Hospitalization for Failure to Thrive: A Prospective Descriptive Report.

Area of Science:

• Pediatrics
• Child Health
• Clinical Nutrition

Background:

• Failure to thrive (FTT) is a frequent reason for pediatric hospitalization.
• Existing literature on FTT is outdated, predating current medical complexities in hospitalized children.

Purpose of the Study:

• To characterize children hospitalized for FTT in a tertiary care pediatric hospital.
• To update the understanding of FTT in a contemporary hospitalized pediatric population.

Main Methods:

• Prospective data collection on 92 consecutive children admitted with FTT.
• Inclusion of demographic, anthropometric, evaluation, and outcome data.
• Distinguishing between primary nonorganic FTT and primary organic FTT.

Main Results:

• Most children (n = 63) with primary nonorganic FTT improved with behavioral interventions and had negative evaluations.
• Children with primary organic FTT experienced longer hospital stays (7 vs 4 days) and reduced daily weight gain (35 vs 58 g/d).
• Diagnostic investigations (laboratory, radiological, endoscopic) infrequently identified the etiology of FTT.

Conclusions:

• Observation for weight gain is recommended before extensive diagnostic workups for hospitalized children with FTT.
• Behavioral interventions are effective for a majority of FTT cases in this cohort.
• The complexity of hospitalized children with FTT necessitates updated clinical approaches.