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Failure to Thrive

What is failure to thrive?

Failure to thrive is defined as failure to gain weight appropriately for age. The reason for failure to thrive is often inadequate nutrition but can be due to other medical conditions. Severe failure to thrive can negatively impact a child's well-being including their cognitive development and immune function.

What causes failure to thrive?

Failure to thrive has many different causes. 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. Additional possibilities include:

  • refusal to eat

  • restrictive diet

  • dilute formula preparation

  • poor milk supply

  • physical abnormalities or neurological disorders leading to difficulty swallowing or vomiting

  • malabsorption

  • diabetes mellitus

Who is affected by failure to thrive?

Infants can be affected if the right kinds or amounts of food are not given or are unavailable. For example, too much fruit juice, problems breastfeeding, or failure to introduce solids at an appropriate age may lead to too few 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.

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

  • Irritability

  • Easily fatigued

  • Excessive sleepiness

  • Lack of age-appropriate social response (such as smile)

  • Does not make vocal sounds

  • Delayed motor development

  • Learning and behavior difficulties later in childhood

How is failure to thrive diagnosed?

Failure to thrive is usually discovered and diagnosed by the infant's healthcare provider. Infants are always weighed and measured when seen by their healthcare providers for well-baby check-ups. The healthcare provider begins 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 healthcare provider based on:

  • How old your child is

  • His or her overall health and past health

  • How sick he or she is

  • How well your child can handle specific medicines, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

The individual issues involved in causing failure to thrive are almost always complex. Hospitalization may be needed to help determine the underlying cause. Treatment depends on the cause of the condition and may involve a team of healthcare providers. This includes social workers, nutritionists, physical therapists, geneticists, and other specialists.

Online Medical Reviewers:

  • Adler, Liora C, MD
  • Chan, Albert, MD
  • Cunningham, Louise, RN
  • Dozier, Tennille, RN, BSN, RDMS