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Growth at the age of 4 years subsequent to early failure to thrive
Insights
Children with organic failure to thrive (OFTT) showed improved growth by age 4. Nonorganic failure to thrive (NFTT) children experienced sustained growth deficits, especially with high psychosocial risk factors.
Area of Science:
- Pediatrics
- Child Development
- Growth Disorders
Background:
- Failure to thrive (FTT) is a common pediatric concern.
- Distinguishing between organic (OFTT) and nonorganic (NFTT) causes is crucial for prognosis.
- Long-term growth outcomes for these groups require further investigation.
Purpose of the Study:
- To assess the long-term growth trajectories of children with OFTT and NFTT up to age 4.
- To evaluate the impact of psychosocial factors and interventions on NFTT growth.
- To compare growth patterns between OFTT and NFTT cohorts.
Main Methods:
- Follow-up study of 55 children diagnosed with FTT between 4-18 months of age.
- Children categorized into OFTT (n=21) and NFTT (n=34) groups.
- Reinvestigation at age 4, analyzing weight, height, and psychosocial factors.
Main Results:
- OFTT children demonstrated normalized weight and height by age 4, with most conditions resolving.
- NFTT children exhibited significantly lower weight and height (p < .01).
- Intervention in high-risk NFTT children improved growth patterns compared to non-intervention.
Conclusions:
- Children with OFTT generally achieve catch-up growth by age 4.
- NFTT is associated with persistent growth deficits, influenced by psychosocial factors.
- Early psychosocial intervention can positively impact growth in at-risk children.
Abstract:
Fifty-five children previously investigated for failure to thrive (a rate of weight gain below -2 SD) during at least 6 weeks at 4-18 months of age were followed up and reinvestigated at the age of 4 years. The children were studied in two groups: children with organic causes (OFTT) (n = 21); and children for whom no organic cause was found (nonorganic failure to thrive, NFTT) (n = 34). In children with OFTT, normalization of growth was found for both weight and height attained, as most of the diseases were either amenable to treatment or spontaneously subsided. The only exception was a child with severe encephalopathy. In children with NFTT, much lower values were found, particularly for weight, p less than .01 for both weight and height. Children with a low psychosocial score (less than or equal to 3 adverse factors) showed partial catch-up growth, although significantly lower than that of children with OFFT. Among 13 children with high psychosocial scores (greater than or equal to 4), 6 children had been subjected to strong social and/or psychological intervention. These children showed a more favorable growth pattern compared to children with comparable psychosocial scores where no intervention had been undertaken. The children with NFTT continued to grow slowly, remained meager and seemed to maintain a suboptimal growth pattern, particularly those with higher numbers of risk factors.