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Persistent failure-to-thrive: a case study

P K Lemons1, N N Dodge

  • 1Riley Children's Hospital, Indiana University Medical Center, Indianapolis 46202-5210, USA.

Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
|March 27, 1998
PubMed

Insights

Addressing infant feeding difficulties requires managing both physical and behavioral issues. This case study explores nonregurgitant gastroesophageal reflux and behavioral interventions for persistent failure-to-thrive.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Developmental Psychology

Background:

  • Infant feeding problems and growth failure cause significant parental and clinical concern.
  • Early growth failures often indicate difficulties with infant homeostasis, requiring medical management of physical issues.
  • Behavioral problems frequently accompany growth failure and necessitate integrated treatment approaches.

Observation:

  • A case study involving a child with poor growth and respiratory symptoms due to nonregurgitant gastroesophageal reflux is presented.
  • Nonregurgitant gastroesophageal reflux is a challenging clinical entity to diagnose.
  • Surgical intervention for the reflux was successful, yet the child's failure-to-thrive persisted.

Findings:

  • The study discusses the use of cyproheptadine as an appetite stimulant for persistent poor weight gain.
  • A review of current literature on pharmacologic approaches to poor weight gain is included.
  • A behavioral-based treatment plan is described as an alternative to pharmacologic interventions.

Implications:

  • Recognizing and managing nonregurgitant gastroesophageal reflux is crucial for infant growth.
  • Integrated medical and behavioral management is essential for addressing complex feeding and growth issues.
  • Behavioral interventions offer a viable alternative to pharmacologic agents for promoting weight gain in challenging cases.

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