Failure to Thrive
What is failure to thrive?
Failure to thrive is defined as decelerated or arrested physical growth (height and
weight measurements fall below the third or fifth percentile, or a downward change
in growth across two major growth percentiles) and is associated with abnormal growth
and development. The reason for failure to thrive is inadequate nutrition. Previously,
failure to thrive was categorized as either organic (underlying medical condition)
or non-organic (no known medical condition). However, this categorization is considered
outdated as the causes and effects of malnutrition are usually intertwined in most
What causes failure to thrive?
Failure to thrive has many different causes, and sometimes more than one cause may
contribute to the condition at the same time. If an infant is not offered enough food
or is not willing to eat enough food, or vomits repeatedly (such as with severe gastroesophageal
reflux), there will not be enough calories to support growth. A child who is unable
to absorb enough calories (such as with severe allergies or a medical condition like
cystic fibrosis) will also not grow as expected. Any condition that causes a child
to need more calories than normally expected may also lead to failure to thrive.
Who is affected by failure to thrive?
Infants born into families with inadequate support or understanding of infant needs
may not provide the right kinds or amounts of food. For example, too much fruit juice,
problems breastfeeding, or failure to introduce solids at an appropriate age may lead
to too little calories being consumed. Babies and children with developmental delay
or problems swallowing may consume too few calories. Conditions such as cystic fibrosis,
celiac disease, or severe allergy or intolerance may consume enough food but not be
able to absorb it properly. A child with a chronic medical condition, such as congenital
heart disease or a genetic syndrome, may need more calories than expected. In severe
cases, neglect or abuse may be associated with failure to thrive if food is purposely
withheld from a baby.
What are the symptoms of failure to thrive?
The following are the most common symptoms of failure to thrive. However, each child
may experience symptoms differently. Symptoms may include:
Lack of appropriate weight gain
Lack of age-appropriate social response (i.e., smile)
Does not make vocal sounds
Delayed motor development
Learning and behavior difficulties later in childhood
The symptoms of failure to thrive may resemble other conditions or medical problems.
Always consult your child's physician for a diagnosis.
How is failure to thrive diagnosed?
Failure to thrive is usually discovered and diagnosed by the infant's physician. Infants
are always weighed and measured when seen by their physicians for well-baby check-ups.
The physician initiates a more complete evaluation when the infant's growth, development,
and functioning are found to be delayed.
Treatment for failure to thrive
Specific treatment for failure to thrive will be determined by your child's physician
Your child's age, overall health, and medical history
Extent of your child's symptoms
Cause of the condition
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
The individual issues involved in causing failure to thrive are almost always complex.
Treatment depends on the cause of the condition and may involve a team of health care
providers, including social workers, nutritionists, physical therapists, geneticists,
and other specialists.