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Growth Faltering and Failure to Thrive in Children.

Emily T Goodwin1, Katie L Buel2, Laurel D Cantrell1

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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.

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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.