Failure to Thrive
From Holoprosencephaly
Failure to Thrive
This is a condition in which a child’s weight and height (or both) consistently fall below the 3rd percentile.
Without intervention, this problem may become chronic and life threatening. It is important to determine whether failure to thrive results from medical problems or factors in the environment, such as abuse or neglect. Failure to thrive (FTT) is classified as organic, non-organic or mixed. Organic FTT results from a disease or disorder, such as chromosome abnormalities, defects in major organ systems, damage to the brain or central nervous system that directly affect feeding ability and patterns, anemia or other blood disorders, gastrointestinal problems that result in malabsorption or a lack of digestive enzymes, GERD and metabolic disorders.
Non-organic FTT is not associated with a disease or disorder. This may involve a psychosocial problem between the child and caregiver, such as emotional deprivation as a result of parental withdrawal, rejection, or hostility or the result of neglect or abuse. Other causes may be related to economic problems that affect nutrition, living conditions, and parental attitudes; or poor eating habits, such as eating in front of the television and not having formal meal times.
Mixed FTT results from a combination of organic and non-organic causes.
Symptoms
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.
Also: History of poor feeding, poor appetite and/or poor sucking reflex Crying during feeding Vomiting during or immediately after feeding Evident signs of malnutrition- emaciation may be present Infants may be floppy or unresponsive
In cases of non-organic FTT, child may avoid eye contact and physical contact with caregiver. Also, caregiver may demonstrate a negative reaction toward child.
Signs and tests
The doctor will perform a physical exam and check the person's height, weight, and body shape.
A detailed history is taken, including prenatal, birth, neonatal, psychosocial, and family information.
Developmental screening tests completed to determine delayed development.
A growth chart outlining all types of growth since birth is created.
Blood and urine laboratory tests
X-rays to determine bone age
Treatment
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.
Medical treatment is provided for infections, anemia, metabolic imbalances and gastrointestinal problems.
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.
Expectations (prognosis)
It is extremely important that caregivers provide adequate attention to feeding problems and take children for routine physical examinations. 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.
For information about dealing with other potential health problems, treatments and medications, please visit our Miscellaneous Health Information category.
Click here to read what specialists have to say about caring for children with Holoprosencephaly: Doctor Q&A
If you have any concerns, please don't hesitate to discuss your concerns with your child's doctor(s).
