Failure-to-thrive is when a child is not growing as expected. The child's height and weight are often below that of other children their age.
Failure-to-thrive is caused by a lack of nutrition. This may be from:
- Not eating enough food
- Not absorbing the nutrients from food due to problems such as celiac disease or cystic fibrosis
- Burning more calories than normal due to problems such as insulin resistance or hyperthyroidism
Failure to thrive is more common in babies who are born very early and those who are born with a low birth weight. Other things that may raise the risk are:
- Birth abnormalities, such as laryngomalacia or congenital heart defects
- Developmental delay
- Gastroesophageal reflux disease (GERD)
- Eosinophilic esophagitis—an allergic disease that causes swelling in the tube that connects the mouth to the stomach
- Poor oral health, such as cavities
Copyright © 2002 Nucleus Communications, Inc. All rights reserved.http://services.epnet.com/getimage.aspx?imageiid=24722472si1347.jpgGastroesophageal RefluxNULLjpgGastroesophageal RefluxNULL\\filer01\Intellect\images\si1347.jpgCopyright © 2002 Nucleus Communications, Inc. All rights reserved.26NULL2002-10-012553912472_11872261400Copyright © Nucleus Medical Media, Inc.
Family and social risk factors may be:
- Financial problems that make it hard to buy food
- Poor use of feeding methods
- Family stress
- Poor parenting skills
- Post-partum depression
- Lack of social support for the parent(s)
- Abuse or violence in the family
- Substance abuse in the parent(s)
- Unusual ideas about health or nutrition
The main symptom of failure to thrive is slowed height growth and weight growth. Other problems may be:
- Delayed motor skills, such as late rolling, sitting, crawling, standing, walking, or talking
- Weakness, low energy
- Learning and behavior problems
The doctor will ask about the child's symptoms and past health. A physical exam will be done. It will include measurements of height, weight, and body mass. This is often enough to make the diagnosis.
More tests may be done to look for what is causing the problem.
Any underlying problems causing failure-to-thrive will be treated. The goal of treatment will be to improve nutrition and boost growth. This can be done with:
- Diet changes to support growth
- Using a feeding tube in children with severe symptoms
- Zinc supplementation—to help the child catch up with growth
Family and social support may also be needed. This can be done with parent training and family counseling.
The risk of failure-to-thrive may be lowered with regular doctor visits to check for growth problems.
- Failure to thrive. Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/parent/growth/growth/failure_thrive.html.
- Failure to thrive in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/failure-to-thrive-in-children.
- Lezo A, Baldini L, Asteggiano M. Failure to Thrive in the Outpatient Clinic: A New Insight. Nutrients. 2020 Jul 24;12(8):2202.
- National Institute for Health and Care Excellence (NICE) guideline on recognition and management of faltering growth. NICE 2017 Sep:NG75.
- Daniel Ostrovsky, MD
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