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Failure to thrive: an update.

Sarah Z Cole¹, Jason S Lanham

¹Mercy Family Medicine Residency, St. John's Mercy Medical Center, St. Louis, MO, USA.

American Family Physician

|April 29, 2011

Summary

Failure to thrive (FTT) in children stems from insufficient calorie intake or absorption. Early intervention with multidisciplinary support improves outcomes, though long-term cognitive effects remain uncertain.

Area of Science:

Pediatrics
Nutrition Science
Child Development

Background:

Failure to thrive (FTT) affects 5-10% of US children in primary care.
Defined by weight-for-age below 5th percentile or significant growth deceleration.
Most FTT cases result from inadequate caloric intake due to behavioral or psychosocial factors.

Purpose of the Study:

To review the evaluation and management of pediatric failure to thrive.
To highlight the importance of accurate caloric intake assessment.
To discuss treatment strategies and long-term implications.

Main Methods:

Review of clinical definitions and diagnostic indicators for FTT.
Emphasis on outpatient evaluation, focusing on dietary history.

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Criteria for hospitalization and recommended multidisciplinary treatment approaches.

Main Results:

Single indicators for FTT have low predictive value.
Accurate assessment of eating habits is crucial for diagnosis.
Multidisciplinary treatment, including home nursing and nutritional counseling, enhances weight gain and parent-child interactions.

Conclusions:

FTT evaluation prioritizes accurate caloric intake assessment over routine labs.
Hospitalization is reserved for refractory cases, suspected abuse, or severe caregiver impairment.
While short-term outcomes improve with intervention, long-term cognitive and academic impacts of FTT require further research.