Failure-to-thrive is when a child is not growing as expected. It does not include children who are small for their age. The exact definition is not completely agreed upon.
grow quickly in the first few years of life. A child with failure-to-thrive will have a height and weight that is well below other children of their age. Your child may have also had a normal growth pattern that began to slow down. Initially the child has similar height and weight than their peers but at follow-up appointments the child's height and weight does not keep up with their peers.
In general, failure-to-thrive means that a child:
- Is at or below the 3rd to 5th percentile for height and weight. T
- Has failed to grow as expected. This is shown by dropping two growth percentiles. For example, the child goes from the 75th percentile to below the 25th percentile.
Failure-to-thrive is split into several types according to the cause.
- Organic failure-to-thrive—caused by some other medical condition
- Nonorganic failure-to-thrive—occurs in children with no known medical condition
- Mixed failure-to-thrive—occurs when the child has features of both organic and nonorganic failure-to-thrive
Failure-to-thrive is diagnosed based on following a child's growth. The doctor will plot your child's weight, height, and head circumference on standard growth charts. If the child falls below a certain weight range or drops two percentiles on the growth chart, the doctor will evaluate the child further.
If a medical condition may be the cause, the doctor will order further tests. The type of tests will depend on the condition.
Sometimes, a child must be hospitalized for a period of time to find the cause of failure-to-thrive. During this time the doctor will:
- Monitor the relationship between parent and child, paying particular attention to their behavior around feeding
- Set up a feeding schedule with an adequate amount of calories
- Make sure that an appropriate feeding technique is used
If the child can gain weight under these circumstances, this supports the diagnosis of nonorganic failure-to-thrive.
Treatment may include:
Treating a Medical Condition
Treating the underlying medical condition may correct failure-to-thrive.
Providing Extra Calories
Children who are malnourished may need liquid supplements. They can help to boost their weight and nutrition.
When a child is hospitalized for diagnosis, the hospital staff can also provide treatment. Nurses can teach parents appropriate feeding techniques. They may also show how to best interact with their child. If the child isn't hospitalized, parents can still have training sessions with a nutritionist or a nurse.
Parents and children who are having difficulty with their relationship may benefit from counseling.