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Evaluation and prognosis in nonorganic failure to thrive
Insights
Failure to thrive (FTT) in children is often non-organic, stemming from feeding issues or environmental deprivation. Diagnostic evaluations had limited value, with outcomes varying based on the cause.
Area of Science:
- Pediatrics
- Child Health
- Growth Disorders
Background:
- Failure to thrive (FTT) is a common pediatric concern.
- Determining the etiology of FTT is crucial for effective management.
- Organic causes are often suspected but may be less prevalent than non-organic factors.
Purpose of the Study:
- To review the diagnostic process and outcomes for children hospitalized with FTT.
- To identify the primary causes of FTT in a pediatric hospital setting.
- To evaluate the utility of extensive laboratory investigations in diagnosing FTT.
Main Methods:
- Retrospective review of 70 children admitted with FTT over five years.
- Analysis of diagnostic evaluations, including laboratory data.
- Categorization of FTT causes into organic, improper feeding, environmental deprivation, and unknown.
Main Results:
- Only 16% of FTT cases were attributed to organic disorders.
- Improper feeding (45%) and environmental deprivation (52%) were the main non-organic causes.
- Extensive laboratory data provided limited diagnostic value; 30% were discharged without a diagnosis.
Conclusions:
- Non-organic factors, particularly feeding issues and environmental deprivation, are significant contributors to FTT.
- The diagnostic yield of extensive laboratory testing for FTT is often low.
- Prognosis for FTT varies, with children experiencing environmental deprivation or unknown causes having poorer outcomes compared to those with feeding issues.
Abstract:
The 70 children with failure to thrive (FTT) admitted to our hospital over the last five years were reviewed. After extensive evaluations, only 16% received a diagnosis of an organic disorder. In the nonorganic group, 45% of FTT was secondary to improper feeding and 52% was secondary to environmental deprivation. Thirty percent of the children were discharged without a diagnosis. Although there were some important differences between the groups, extensive laboratory data were of little value. Follow-up information revealed that while the children with FTT secondary to poor feeding technics uniformly did well, the outlook for the environmentally deprived group and unknown cause group was frequently poor.