DOI QR코드

DOI QR Code

Nutritional approach to failure to thrive

  • Jeong, Su-Jin (Department of Pediatrics, CHA Bundang Medical Center, CHA University)
  • Received : 2011.05.16
  • Accepted : 2011.05.27
  • Published : 2011.07.15

Abstract

Failure to thrive (FTT) is a term generally used to describe an infant or child whose current weight or rate of weight gains is significantly below that expected of similar children of the same age, sex and ethnicity. It usually describes infants in whom linear growth and head circumference are either not affected, or are affected to a lesser degree than weight. FTT is a common problem, usually recognized within the first 1-2 years of life, but may present at any time in childhood. Most cases of failure to thrive involve inadequate caloric intake caused by behavioral or psychosocial issues. The most important part of the outpatient evaluation is obtaining an accurate account of a child's eating habits and caloric intake. Routine laboratory testing rarely identifies a cause and is not generally recommended. FTT, its evaluation, and its therapeutic interventions are best approached by a multi-disciplinary team includes a nutritionist, a physical therapist, a psychologist and a gastroenterologist. Long term sequelae involving all areas of growth, behavior and development may be seen in children suffering from FTT. Early detection and early intervention by a multidisciplinary team will minimize its long term disadvantage. Appropriate nutritional counseling and anticipatory guidance at each well child visit may help prevent some cause of FTT.

Keywords

References

  1. Olsen EM, Petersen J, Skovgaard AM, Weile B, Jorgensen T, Wright CM. Failure to thrive: the prevalence and concurrence of anthropometric criteria in a general infant population. Arch Dis Child 2007;92:109-14.
  2. Jolley CD. Failure to thrive. Curr Probl Pediatr Adolesc Health Care 2003;33:183-206. https://doi.org/10.1016/S1538-5442(03)00020-8
  3. de Onis M, Garza C, Onyango AW, Borghi E. Comparison of the WHO child growth standards and the CDC 2000 growth charts. J Nutr 2007;137:144-8.
  4. Olsen EM. Failure to thrive: still a problem of definition. Clin Pediatr (Phila) 2006;45:1-6. https://doi.org/10.1177/000992280604500101
  5. Zenel JA Jr. Failure to thrive: a general pediatrician's perspective. Pediatr Rev 1997;18:371-8.
  6. Shah MD. Failure to thrive in children. J Clin Gastroenterol 2002;35:371- 4. https://doi.org/10.1097/00004836-200211000-00002
  7. Roche AF, Sun SS. Human growth: assessment and interpretation. Cambridge (UK): Cambridge University Press, 2003.
  8. Bergman P, Graham J. An approach to "failure to thrive". Aust Fam Physician 2005;34:725-9.
  9. Bithoney WG, Dubowitz H, Egan H. Failure to thrive/growth deficiency. Pediatr Rev 1992;13:453-60.
  10. Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics 2007;120:e1069-75. https://doi.org/10.1542/peds.2006-2961
  11. Emond A, Drewett R, Blair P, Emmett P. Postnatal factors associated with failure to thrive in term infants in the Avon Longitudinal Study of Parents and Children. Arch Dis Child 2007;92:115-9.
  12. McDougall P, Drewett RF, Hungin AP, Wright CM. The detection of early weight faltering at the 6-8-week check and its association with family factors, feeding and behavioural development. Arch Dis Child 2009;94:549-52. https://doi.org/10.1136/adc.2008.139063
  13. Cole SZ, Lanham JS. Failure to thrive: an update. Am Fam Physician 2011;83:829-34.
  14. Wright CM. Identification and management of failure to thrive: a community perspective. Arch Dis Child 2000;82:5-9. https://doi.org/10.1136/adc.82.1.5
  15. Gomez F, Ramos Galvan R, Frenk S, Cravioto Muñoz J, Chávez R, Vázquez J. Mortality in second and third degree malnutrition. 1956. Bull World Health Organ 2000;78:1275-80.
  16. Careaga MG, Kerner JA Jr. A gastroenterologist's approach to failure to thrive. Pediatr Ann 2000;29:558-67. https://doi.org/10.3928/0090-4481-20000901-08
  17. Hren I, Mis NF, Brecelj J, Campa AS, Sedmak M, Krzisnik C, et al. Effects of formula supplementation in breast-fed infants with failure to thrive. Pediatr Int 2009;51:346-51. https://doi.org/10.1111/j.1442-200X.2008.02732.x
  18. Showers J, Mandelkorn R, Coury DL, McCleery J. Nonorganic failure to thrive: identification and intervention. J Pediatr Nurs 1986;1:240-6.
  19. Rathbun JM, Peterson KE. Nutrition in failure to thrive. In: Grand RJ, Sutphen JL, Dietz WH, editors. Bosron: Butterworths, 1987;629-43.
  20. Khoshoo V, Reifen R. Use of energy-dense formula for treating infants with non-organic failure to thrive. Eur J Clin Nutr 2002;56:921-4. https://doi.org/10.1038/sj.ejcn.1601406
  21. Clarke SE, Evans S, Macdonald A, Davies P, Booth IW. Randomized comparison of a nutrient-dense formula with an energy-supplemented formula for infants with faltering growth. J Hum Nutr Diet 2007;20:329- 39. https://doi.org/10.1111/j.1365-277X.2007.00805.x
  22. Sullivan PB, Goulet O. Growth faltering: how to catch up? Eur J Clin Nutr 2010;64 Suppl 1:S1.
  23. Bauchner H. Failure to thrive. In: Kliegman RM, Behrman RE, Jeason HB, Stenton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders, 2007:184-6.
  24. Frank DA, Zeisel SH. Failure to thrive. Pediatr Clin North Am 1988;35: 1187-206. https://doi.org/10.1016/S0031-3955(16)36578-6
  25. Couluris M, Mayer JL, Freyer DR, Sandler E, Xu P, Krischer JP. The effect of cyproheptadine hydrochloride (periactin) and megestrol acetate (megace) on weight in children with cancer/treatment-related cachexia. J Pediatr Hematol Oncol 2008;30:791-7. https://doi.org/10.1097/MPH.0b013e3181864a5e
  26. Sandberg DE. Should short children who are not deficient in growth hormone be treated? West J Med 2000;172:186-9. https://doi.org/10.1136/ewjm.172.3.186
  27. Rudolf MC, Logan S. What is the long term outcome for children who fail to thrive? A systematic review. Arch Dis Child 2005;90:925-31. https://doi.org/10.1136/adc.2004.050179
  28. Black MM, Dubowitz H, Krishnakumar A, Starr RH Jr. Early intervention and recovery among children with failure to thrive: follow-up at age 8. Pediatrics 2007;120:59-69. https://doi.org/10.1542/peds.2006-1657

Cited by

  1. Randomized Controlled Trial to Compare Growth Parameters and Nutrient Adequacy in Children with Picky Eating Behaviors Who Received Nutritional Counseling With or Without an Oral Nutritional Supplemen vol.7, pp.None, 2014, https://doi.org/10.4137/nmi.s15097
  2. Micronutrients Are Not Deficient in Children with Nonorganic Failure to Thrive vol.22, pp.2, 2011, https://doi.org/10.5223/pghn.2019.22.2.181
  3. Primary Barriers of Adherence to a Structured Nutritional Intervention in Patients with Dyslipidemia vol.13, pp.6, 2011, https://doi.org/10.3390/nu13061744