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Biopsychosocial characteristics of children admitted with failure to thrive

Mudita Tiwari1,2,3, Wafa Kulsoom Khan1,2, Alison Poulton1,2

  • 1Faculty of Medicine and Health, Nepean Clinical School, University of Sydney, Sydney, Australia.

Journal of Paediatrics and Child Health
|June 29, 2023
PubMed

Insights

Failure to thrive (FTT) in children has distinct organic (OFTT) and non-organic (NOFTT) classifications. OFTT involves medical issues, while NOFTT shows caregiver feeding problems, with both groups facing high psychosocial risks.

Area of Science:

  • Pediatric Medicine
  • Child Development
  • Nutritional Science

Background:

  • Failure to thrive (FTT) is a critical concern in pediatrics, necessitating a comprehensive understanding of its diverse etiologies.
  • Differentiating between organic FTT (OFTT) with underlying medical conditions and non-organic FTT (NOFTT) without them is crucial for effective management.
  • Biopsychosocial factors significantly influence a child's growth and development, impacting FTT presentation and outcomes.

Purpose of the Study:

  • To characterize and compare the biopsychosocial profiles of children with FTT.
  • To investigate differences between organic FTT (OFTT) and non-organic FTT (NOFTT) in medical, nutritional, feeding skills, and psychosocial domains.
  • To inform clinical practice regarding the assessment and management of FTT.

Main Methods:

  • Retrospective review of medical records for children admitted with FTT between January 2010 and December 2020.
  • Inclusion of 353 children, categorized into OFTT and NOFTT groups.
  • Descriptive statistical analysis to compare group characteristics.

Main Results:

  • Approximately half of the FTT cases were classified as OFTT, presenting with lower birth weights and a history of intrauterine growth restriction.
  • Children with OFTT exhibited delayed feeding skills and oral aversion, while NOFTT cases showed more abnormal caregiver feeding strategies.
  • Both OFTT and NOFTT groups demonstrated similar high risks for abuse and neglect, with no significant differences in psychosocial domains.

Conclusions:

  • Classifying FTT solely on psychosocial parameters is insufficient, as organic and non-organic groups exhibit distinct medical and feeding strategy differences.
  • A multidisciplinary approach is essential for comprehensive FTT assessment and intervention, addressing the complex interplay of medical, nutritional, and psychosocial factors.
  • Understanding these distinctions aids in tailoring interventions for improved growth and developmental outcomes in children with FTT.
Abstract

Keywords:
failure to thrivegrowth falteringpoor weight gain

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