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Failure to thrive. A continuing problem of definition
W D Wilcox1, P Nieburg, D S Miller
1Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30303.
Insights
Failure to thrive (FTT) lacks a clear definition despite its common use. This review found inconsistent quantitative criteria across pediatric texts and journals, hindering accurate diagnosis and research.
Area of Science:
- Pediatrics
- Child Nutrition
- Gastroenterology
Background:
- "Failure to thrive" (FTT) is a term used for over 50 years to describe growth deficits in infants and young children.
- Current usage often links FTT to growth failure from insufficient caloric intake or maternal deprivation.
- Despite its prevalence, FTT lacks a precise, universally accepted definition.
Purpose of the Study:
- To assess the clarity and consistency of the definition of "failure to thrive" (FTT) in current medical literature.
- To identify the quantitative criteria and anthropometric indices used to define FTT in pediatric reference texts and journals.
Main Methods:
- A systematic review of 22 general pediatrics, pediatric nutrition, and pediatric gastroenterology reference texts.
- Analysis of 13 recent journal articles that address "failure to thrive" (FTT).
Main Results:
- Only 9 of 22 reference texts and 9 of 13 journal articles provided quantitative definitions for FTT.
- Significant lack of consensus was observed regarding the specific anthropometric indices and abnormality criteria used.
- The existing literature demonstrates ambiguity in defining FTT.
Conclusions:
- The absence of a standardized, scientifically validated definition for "failure to thrive" (FTT) contributes to an ambiguous body of research.
- A clear, dynamic definition is needed to accurately reflect the syndrome and improve diagnostic consistency.
- Further research is required to establish consensus on FTT definition and diagnostic criteria.
Abstract:
The term "failure to thrive" (FTT) has been used for more than 50 years to describe the infant or young child whose growth falls substantially behind that of his or her peers. Currently, the predominant use of FTT is to describe a child's growth failure resulting from caloric or maternal deprivation or both. Despite widespread use, the term FTT lacks a clarified definition. In this study the authors review 22 current reference texts in general pediatrics, pediatric nutrition, and pediatric gastroenterology and 13 recent journal articles addressing FTT. Only 9 of the 22 texts and 9 of the 13 journal articles describe FTT in quantitative terms, but even these references lack consensus on the anthropometric indices used and their criteria for abnormality. The absence of a standard, scientifically credible definition for FTT, which reflects the dynamic nature of this syndrome, continues to produce an ambiguous body of literature on the subject.