Title: Failure to Thrive in Childhood
Type of Paper: Review Article
Purpose: To overview the diagnostic criteria and treatment of failure to thrive (FTT) in childhood in developed countries.
Methods: Articles published between 1995 and October 2010 that contained the terms “failure to thrive,” “malnutrition,” “malabsorption,” “maldigestion,” “underweight,” and “refeeding syndrome” were reviewed.
Results: Results of the review could be summarized into five recommended steps to be taken in cases of FTT:\
- Diagnosis of FTT
Weight, length and weight-for-length are the most objective parameters for establishing nutritional status. Deviations typical in children with FTT include:
- Weight-for-length or BMI below the 3rd percentile
- Weight below the 3rd percentile
- Lack of weight and length gain with percentile deviations greater than 2 main percentiles
Development should be assessed on percentile curves over time, using population-specific and time-related data.
- Identification of the cause of FTT
FTT is not a disease in and of itself but a symptom that accompanies an underlying disease. Malnutrition/FTT is often caused by:
- Insufficient food intake: This is with many chronic intestinal, psychosocial and psychiatric diseases.
- Increased energy requirements: This may be due to metabolic diseases, or increased respiratory effort or increased restlessness in neurological diseases.
- Malabsorption: This is often characterized by chronic diarrhea and/or increased fat content in the stools.
- Increased food intake
- Enrichment of food
- Nutritional drinks
- Tube feeding
- Parenteral (intravenous) feeding
Conclusions: Treating FTT in children involves addressing malnutrition and its underlying behavioral and non-behavioral causes.
Citation/Reference: Nutzenadel, W. Failure to Thrive in Childhood. Deutsches Arzteblatt International. 2011; 108(38): 642-649. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198227/