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Failure to thrive

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Alternative Names   

Growth failure; FTT

Definition    Return to top

Failure to thrive is a description applied to children whose current weight or rate of weight gain is significantly below that of other children of similar age and sex.

Causes    Return to top

Infants or children that fail to thrive seem to be dramatically smaller or shorter than other children the same age. Teenagers may have short stature or appear to lack the usual changes that occur at puberty. However, there is a wide variation in normal growth and development.

In general, the rate of change in weight and height may be more important than the actual measurements.

It is important to determine whether failure to thrive results from medical problems or factors in the environment, such as abuse or neglect.

There are multiple medical causes of failure to thrive. These include:

Other factors that may lead to failure to thrive:

Many times the cause cannot be determined.

Symptoms    Return to top

Infants or children who fail to thrive have a height, weight, and head circumference that do not match standard growth charts. The person's weight falls lower than 3rd percentile (as outlined in standard growth charts) or 20% below the ideal weight for their height. Growing may have slowed or stopped after a previously established growth curve.

The following are delayed or slow to develop:

Exams and Tests    Return to top

The doctor will perform a physical exam and check the child's height, weight, and body shape. A detailed history is taken, including prenatal, birth, neonatal, psychosocial, and family information.

A Denver Developmental Screening Test reveals delayed development. A growth chart outlining all types of growth since birth is created.

The following laboratory tests may be done:

Treatment    Return to top

The treatment depends on the cause of the delayed growth and development. Delayed growth due to nutritional factors can be resolved by educating the parents to provide a well-balanced diet.

If psychosocial factors are involved, treatment should include improving the family dynamics and living conditions. Parental attitudes and behavior may contribute to a child's problems and need to be examined. In many cases, a child may need to be hospitalized initially to focus on implementation of a comprehensive medical, behavioral, and psychosocial treatment plan.

Do not give your child dietary supplements like Boost or Ensure without consulting your physician first.

Outlook (Prognosis)    Return to top

If the period of failure to thrive has been short, and the cause is determined and can be corrected, normal growth and development will resume. If failure to thrive is prolonged, the effects may be long lasting, and normal growth and development may not be achieved.

Possible Complications    Return to top

Permanent mental, emotional, or physical delays can occur.

When to Contact a Medical Professional    Return to top

Call for an appointment with your health care provider if your child does not seem to be developing normally.

Prevention    Return to top

The best means of prevention is by early detection at routine well-baby examinations and periodic follow-up with school-age and adolescent children.

Update Date: 9/28/2007

Updated by: Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

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