Failure to Thrive

Your child may be diagnosed with failure to thrive if he or she falls below a healthy weight and shows signs of emotional underdevelopment. Typically, failure to thrive is discovered during a child’s infant years.

Ideal weight is determined by comparing your child’s weight, age, and gender to national averages. Children who fail to thrive usually fall well below their ideal weight. A child may also fail to thrive if his or her growth rate stalls when it should be on an upward trend. Ask you doctor for a chart that lists ideal height and weight ranges for children to help monitor your child’s development. The U.S. Centers for Disease Control and Prevention (CDC) also offers a chart that you can use as a reference.

Organic Causes

Some cases of failure to thrive are organic (i.e., medical) in nature. Conditions that cause failure to thrive include (but are not limited to) Down syndrome, cerebral palsy, heart disease, infections, milk allergy, metabolic disorders, and reflux.

Children who suffer from serious medical problems during the first two years of life are more likely to fail to thrive than those who do not. Risk factors vary based on the underlying condition. They may include:

• premature birth
• low birth weight
• history of infections
• poor feeding habits

Nonorganic Causes

Nonorganic failure to thrive occurs when delayed growth is not due to illness. If identified, the causes may include poor nutrition, neglect, abuse, or mental trauma.

Nonorganic failure to thrive is typically a result of environmental factors. These factors can increase your child’s risk:

• poverty
• parents with a history of depression or other mental disorders
• an inconsistent feeding schedule

Generally, an affected child’s weight falls below the third percentile on standard growth charts. The CDC offers a growth chart that you can use as a reference.

Your child may have an unsteady rate of growth. Some children who fail to thrive exhibit the following symptoms:

• delays in reaching developmental milestones such as rolling over, crawling, and talking
• learning disabilities
• lack of emotions such as smiling, laughing, or making eye contact
• fatigue
• irritability
• delayed puberty in teens

Regular checkups can prevent failure to thrive. These should begin during your pregnancy and continue through adulthood. Your child’s growth should be regularly plotted on growth charts.

A child with failure to thrive may be small compared to other children of the same age and gender. His or her growth pattern may not be steady. Have regular checkups with a pediatrician to get the most accurate analysis of your child’s growth.

Because failure to thrive can lead to permanent mental, emotional, and physical delays, it is important to have regular checkups so that doctors can monitor your child’s health.

Tests can assess the effect failure to thrive has on your child’s health and growth. These may include blood tests, urine tests, X-rays, and developmental screenings. Doctors also use these tests to determine whether failure to thrive is organic or nonorganic. Caregivers may need counseling if the doctor suspects that unhealthy practices in the family are to blame.

Treatment options vary depending on these factors:

• whether failure to thrive is organic or nonorganic
• the severity of symptoms
• the overall health of the child
• the preferences of parents or caretakers
• the family environment

Some cases of organic failure to thrive may be resolved once underlying medical conditions are treated. If failure to thrive requires further care, the child’s doctor may prescribe nutritional supplements or a special diet.

When nonorganic failure to thrive is linked to problems at home, social services may be consulted. Severe failure to thrive may be treated in the hospital by using feeding tubes to give the child extra nourishment.

After your child’s growth has reached normal levels, he or she may need help to keep physical and mental growth on track. Physical therapists, speech therapists, occupational therapists, dietitians, and other specialists may be able to help your child.

If failure to thrive is treated early, your child should be able to grow normally, barring any serious medical issues. Failure to thrive that is not treated can result in long-term complications, including learning disabilities, emotional problems, and short stature.