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Growth Faltering and Failure to Thrive in Children.
Emily T Goodwin1, Katie L Buel2, Laurel D Cantrell1
1Naval Hospital Jacksonville Family Medicine Residency Program, Jacksonville, Florida.
Growth faltering in children, previously failure to thrive, occurs when growth metrics are below expected. Early identification and management, using anthropometric z scores, are crucial for optimal development and preventing long-term issues.
Area of Science:
- Pediatrics
- Nutrition Science
- Child Development
Background:
- Growth faltering, formerly failure to thrive, affects children failing to meet expected weight, length, or BMI milestones.
- Traditional growth assessment methods can be imprecise; anthropometric z scores are now recommended for accurate malnutrition severity assessment.
- Inadequate caloric intake is the primary cause, identified through feeding history and physical exams.
Purpose of the Study:
- To provide an overview of growth faltering diagnosis and management.
- To highlight the importance of updated assessment tools like z scores.
- To emphasize timely intervention for optimal child development.
Main Methods:
- Assessment using World Health Organization and Centers for Disease Control and Prevention growth charts.
- Utilizing anthropometric z scores for precise evaluation of malnutrition.
- Clinical evaluation including feeding history and physical examination.
- Diagnostic testing reserved for severe cases or treatment failure.
- Screening for eating disorders in older children or those with comorbidities.
Main Results:
- Inadequate caloric intake is the most common cause of growth faltering.
- Diagnostic testing is indicated for severe malnutrition, concerning symptoms, or treatment failure.
- Eating disorders should be screened for in specific pediatric populations.
- Primary care physicians can manage most cases, with multidisciplinary teams beneficial for complex cases.
Conclusions:
- Accurate assessment using z scores is vital for managing growth faltering.
- Early recognition and treatment, especially within the first two years, are critical.
- Untreated growth faltering can lead to reduced adult height and cognitive potential.
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