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At least 19 recordsLinked to original sources
PubMed2003

Failure to thrive.

Failure to thrive is a condition commonly seen by primary care physicians. Prompt diagnosis and intervention are important for preventing malnutrition and developmental sequelae. Medical and social factors often contribute to failure to thrive. Either extreme of parental attention (neglect or hypervigilance) can lead to failure to thrive. About 25 percent of normal infants will shift to a lower growth percentile in the first two years of life and then follow that percentile; this should not be diagnosed as failure to thrive. Infants with Down syndrome, intrauterine growth retardation, or premature birth follow different growth patterns than normal infants. Many infants with failure to thrive are not identified unless careful attention is paid to plotting growth parameters at routine checkups. A thorough history is the best guide to establishing the etiology of the failure to thrive and directing further evaluation and management. All children with failure to thrive need additional calories for catch-up growth (typically 150 percent of the caloric requirement for their expected, not actual, weight). Few need laboratory evaluation. Hospitalization is rarely required and is indicated only for severe failure to thrive and for those whose safety is a concern. A multidisciplinary approach is recommended when failure to thrive persists despite intervention or when it is severe.

Child↗
PubMed1995

Nutritional management of failure to thrive.

Failure to thrive, or failure to grow or gain weight, could have several causes that are reviewed in this article. Infant behaviors are discussed, together with nutritional management, catch-up growth, effects of nutritional rehabilitation on body composition, follow-up, and long-term prognosis.

Child↗
PubMed1993

Assessment of the child with failure to thrive.

Failure to thrive is a presenting symptom, rather than a diagnosis. Organic failure to thrive may be caused by defects in food assimilation, excessive loss of ingested calories, increased energy requirements or prenatal insults. Nonorganic failure to thrive may occur accidentally, or it may be related to economic or emotional deprivation, as well as to child abuse or neglect. Assessment of a child with failure to thrive includes a comprehensive history and a thorough physical examination. Some basic laboratory screening tests may be helpful in the evaluation. More extensive investigation may be required, based on the clinical findings and the results of the initial screening tests. Early intervention is essential, because children may develop significant long-term sequelae from nutritional deficiency.

Body Height↗
PubMedDate not supplied

Non-organic failure to thrive.

Failure To Thrive is a phenomenon often encountered in the ambulatory pediatric setting. This disorder is usually classified into two main categories: organic or non-organic/psycho-social depending upon the causative factor(s). The first section of this paper discusses evaluation and assessment of the child suspected of having failure to thrive. The second section deals with specific management techniques which can be implemented by the nurse practitioner in caring for the child with non-organic failure to thrive.

Child↗
PubMed1998

Children investigated for failure to thrive: where are they now?

Failure to thrive remains a common problem accounting for a large number of referrals to paediatric clinics. Some children with failure to thrive undergo extensive investigations including a sweat test to exclude cystic fibrosis. Selecting a group of children who had a sweat test, we chose to compare weight centile data recorded at initial presentation with data collected at routine school-entry medical several years later. It was encouraging to see that most children improved their weight centile with time, regardless of whether a diagnosis had been reached.

Child↗
PubMed1980

Failure to thrive.

Failure to thrive is one of the most common diagnostic problems in pediatrics. The term is applied to describe a still poorly defined entity. We will define failure to thrive, review the frequency of various etiologies, and present a logical approach to this problem.

Adult↗
PubMed2001

Biobehavioral characteristics of infants with failure to thrive.

Failure to thrive (FTT) is a syndrome of growth failure that results in an infant who is behaviorally difficult. The current thinking is that FTT results from a problematic infant-mother interaction, with the infant making a significant contribution to the interactional process. It is possible that the behavioral characteristics of the infant with FTT may be related to underlying physiologic response patterns, specifically, activity of the autonomic nervous system. The purpose of this study is to examine the relationships among behavioral responsiveness, heart rate variability as a marker of autonomic nervous system activity, and nutritional status in infants with FTT. Infants with FTT were matched with healthy growing infants (n = 14 pairs). Results from the study indicated that infants with FTT exhibited considerably more negative behaviors and exhibited low heart rate variability. It appears that there may be a physiologic basis to the behaviors that are exhibited by infants with FTT. Prospective research is needed to further clarify this relationship.

Adult↗
PubMed2003

Selection of growth parameters to define failure to thrive.

Failure to thrive (FTT) is a syndrome of growth failure due to undernutrition. Determining whether an infant has FTT is based on the use of an anthropometric indicator and a selected cutoff value for that indicator. These anthropometric indicators include weight for age, weight for length, and length for age, and the cutoff values include the 10th, 5th, and 3rd percentiles. Each indicator and selected cutoff value provide unique information about an infant's growth. However, these parameters are often used interchangeably to explain the same growth phenomenon. The sensitivity and specificity of each anthropometric indicator are a function of the cutoff value selected and dictate which infants will be classified as having FTT and which infants will be classified as healthy. Depending on the sensitivity and specificity of the indicator, some infants with FTT will be classified as healthy, and some healthy infants will be classified as having FTT. A clear rationale for the selection of an anthropometric indicator and a cutoff value for defining FTT are important for increasing the generalizability of research findings and thereby expanding the current knowledge base related to FTT.

Age Factors↗
PubMed1996

A multidisciplinary approach for the treatment of children with failure to thrive.

Failure to thrive is a complex problem affecting long-term health and development of the child. This paper describes a multidisciplinary approach to management and treatment of children and families where there is a child who is failing to thrive. The experience described in this paper is based on many years work of an interdisciplinary nature involving a Paediatrician, Psychologist and Dietician which lead to the creation of a special clinic for these children in 1993.

Child↗
PubMed1991

The effects of high-energy feeding on energy balance and growth in infants with congenital heart disease and failure to thrive.

Failure to thrive (FTT) in infants with congenital heart disease (CHD) can be attributed to their low energy intakes and high resting energy expenditures. Energy intake, energy expenditure and growth were studied in infants with CHD on normal formula feeds and then on feeds supplemented with glucose polymer to see whether supplementation improved energy retention and growth. Mean gross energy intakes increased by 31.7% on high-energy feeding and mean weight gain improved from 1.3 g/kg per d on control to 5.8 g/kg per d on high-energy feeding. Resting oxygen consumption (VO2 ml/kg per min) was not significantly different on the two feeding regimens, although respiratory quotient rose on high-energy feeding reflecting the increased carbohydrate intake. Estimated energy costs of growth on high-energy feeding fell within the previously described range for normal infants. It is recommended that infants with CHD known to be associated with FTT are fed on high-energy diets from the time of diagnosis in order to optimize growth.

Energy Metabolism↗
PubMed1993

Non-organic failure to thrive: growth failure secondary to feeding-skills disorder.

In this article the authors propose that non-organic failure to thrive (FTT) is a growth failure secondary to feeding-skills disorder, and that this disorder is neurophysiological in origin. The symptoms of feeding-skills disorder were suggestive of an oral sensorimotor impairment which is usually present from birth or early life, but tends to go unrecognized. Data from 38 infants with non-organic and 22 infants with organic FTT demonstrated that early clinical symptoms of feeding impairment, and observed maternal and infant feeding behaviours and interactions, were similar for both groups, suggesting a need to redefine the term 'non-organic'.

Anthropometry↗
PubMed1978

Failure to thrive or failure to rear?

The study group comprised 40 unselected Caucasian children admitted to hospital whose ages were between 3 months and 3 years and whose weights were less than 3rd centile. A comparison group comprised 34 children from a similar background whose weights were between the 25th and 75th contiles. The mothers of all 74 children were interviewed and information was obtained on physical health of the child, social and family factors, bonding, feeding difficulties, and maternal childhood experience. In 23 of the 40 underweight children the organic disease was considered to be insufficient to explain the child being underweight and to be probably insufficient in a further 9 children. Three factors occurred more frequently in these 32 underweight children. The mother often perceived herself as having a disturbed mood and used the word "depression" to describe these feelings. She also tended to come from a lower social class than the mother in the comparison group, and her infant frequently had a low birthweight. Identification of these children is not difficult; clinical investigations need to be minimal, and therapy should be directed towards supporting the mother emotionally, improving her relationship with her child, and increasing her mothering skills.

Body Weight↗
PubMed1996

The role of medications in geriatric failure to thrive.

Geriatric failure to thrive (GFTT) is a syndrome associated with functional decline, depression and malnutrition. Adverse drug reactions are cited as one of the most common causes of GFTT. Two distinct drug-related issues should be considered. Firstly, failure to provide appropriate treatment for conditions such as anaemia, depression, nutritional deficiencies and pain may precipitate GFTT. Secondly, drug-induced functional decline and decreased nutrient intake may cause or contribute to the syndrome. Pharmacological intervention may include discontinuing potentially offending agents for a trial period, or drug treatment of anorexia and depression.

Aged↗
PubMed1987

Characteristics of mother-infant interactions in nonorganic failure to thrive.

Nonorganic failure to thrive (NOFTT) is characterized by physical and developmental retardation and a disturbed mother-infant relationship. This study sought to quantify differences in interactions between mother-NOFTT infant pairs and control mother-thriving infant pairs. Eleven mother-NOFTT infant dyads and 11 control mother-infant dyads were videotaped for 30 minutes through a one-way mirror. Mother and infant behaviors were evaluated for 21 behavioral categories: 12 maternal, 7 infant, and 2 mutual. Statistically significant differences were noted in five (24 percent) categories. The quantity of maternal and infant vocalizations and the responsiveness of the mother to the infant's vocal cues were strikingly reduced in the NOFTT dyads.

Adult↗
PubMed1996

Proteolysis of insulin-like growth factor-binding protein-3 in human immunodeficiency virus-positive children who fail to thrive.

Failure to thrive is a common manifestation of human immunodeficiency virus (HIV) infection in children. Given the role of insulin-like growth factor I (IGF-I) in stimulating postnatal growth, we have examined whether HIV-infected pediatric patients with growth failure have lower serum concentrations of IGF-I than age-matched control subjects. IGF-I was measured in 16 HIV-infected children and 13 HIV-negative controls. Ten of the HIV-infected children failed to thrive based on height and linear growth that was below the National Center for Health Statistics 10th percentile. IGF-I levels were significantly lower in children who failed to thrive compared to those in age-matched controls (20 vs. 60 micrograms/L; P < 0.001). Children who failed to thrive also displayed lower IGF-I levels than HIV-positive children, who exhibited normal growth velocity (20 vs. 91 micrograms/L; P < 0.001). Failure to thrive was associated with a significant reduction in circulating levels of IGF-binding protein-3 (IGFBP-3), as determined by ligand and Western blotting (P < 0.001), enhanced IGFBP-3 proteolysis (P < 0.001), and a decrease in the serum concentration of the acid-labile subunit of the IGFBP-3 ternary complex (P < 0.005). IGFBP-3 proteolysis was negatively correlated with IGF-I (r = 0.78) and IGFBP-3 levels (r = 0.70). Failure to thrive was associated with a reduction in the formation of the ternary complex, but the ternary complex could be restored by the addition of an excess of IGFBP-3 to serum. These results indicate that low levels of IGF-I, IGFBP-3, and acid-labile subunit are associated with a failure to thrive in HIV-infected children.

Blotting, Western↗