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FAILURE TO THRIVE
V Venkateshwar1, T S Raghu Raman2
1Graded Specialist (Paediatrics), 7 Air Force Hospital, Kanpur 208 004.
Insights
Failure to thrive in children is defined as significantly low weight or weight gain. Management requires a multidisciplinary approach addressing nutritional, medical, and psychosocial factors for optimal outcomes.
Area of Science:
- Pediatrics
- Child Health
- Growth and Development
Background:
- Failure to thrive (FTT) is a common pediatric concern, referring to children with attained weight or rate of weight gain significantly below peers.
- Defining criteria help distinguish true FTT from apparent growth failure, with both organic and non-organic (social, psychological, environmental) causes.
- Clinical features include malnutrition, signs of organic disease, and indicators of psychosocial deprivation.
Purpose of the Study:
- To provide a comprehensive overview of failure to thrive in pediatric practice.
- To differentiate true failure to thrive from other growth issues.
- To outline diagnostic and management strategies for FTT.
Main Methods:
- Literature review on failure to thrive in pediatric populations.
- Analysis of diagnostic criteria and clinical features.
- Evaluation of management approaches, including multidisciplinary care and hospitalization.
Main Results:
- FTT encompasses both organic and non-organic etiologies, necessitating a broad diagnostic perspective.
- Indiscriminate laboratory investigations are generally not useful for FTT evaluation.
- Management emphasizes nutritional rehabilitation alongside addressing underlying medical, psychological, social, and environmental factors.
Conclusions:
- Effective management of FTT requires a multidisciplinary approach, with hospitalization playing a specific role.
- Addressing the root causes, whether organic or non-organic, is crucial for successful treatment.
- Long-term physical, developmental, and behavioral sequelae can occur in children with FTT, highlighting the importance of timely intervention.
Abstract:
Failure to thrive is a commonly encountered problem in Paediatric practice. This essentially generic term refers to children whose attained weight or rate of weight gain is significantly below that of other children of similar age and same sex. Several defining criteria have been proposed and help to differentiate true failure to thrive from other conditions causing apparent growth failure. There are numerous organic causes of failure to thrive, but non-organic failure to thrive is also an important entity and is caused by social, psychological and environmental factors. The clinical features are those of malnutrition, signs of underlying organic cause and specific manifestations of environmental/psychosocial deprivation. Indiscriminate laboratory investigations are usually non-contributory and have no role in evaluation. Management requires a multidisciplinary approach and hospitalization has a specific role. Although nutritional rehabilitation is the cornerstone of therapy, treatment of underlying factors-medical, psychological, social and environmental-should receive equally important attention. Long term physical, developmental and behavioural sequelae are known to occur in children with failure to thrive.
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