- Is at or below the 3rd to 5th percentile for height and weight.
- Has failed to grow as expected. This is shown by crossing 2 percentile lines on the growth chart.
- Organic—caused by some medical condition
- Nonorganic—occurs in children with no known medical condition
- Mixed—occurs when the child has features of both
- Inadequate food intake
- Malabsorption—inability of the intestines to properly absorb nutrients from food
- Loss of nutrients, which may occur from excessive vomiting or diarrhea
- Inability to process nutients correctly
- Increased energy expenditure
- Genetic disorders, such as cystic fibrosis , Down Syndrome or Turner syndrome
- Physical defects, such as cleft lip or palate which interfere with feeding
- Gastrointestinal diseases, such as:
- Chronic or untreated urinary tract infections
- Kidney failure
- Undiagnosed food intolerance
- Heart and lung diseases, such as:
- Endocrine diseases, such as diabetes , or thyroid or pituitary gland disorders
- Chronic or congenital infectious diseases such as HIV or toxoplasmosis
- Fetal alcohol syndrome
- Lead poisoning
- Reduced availablity of food
- Giving non-nutritious foods
- Withholding food
- Breastfeeding difficulties
- Depression in the parent
- Lack of knowledge about proper nutrition and typical child growth patterns
- Parent and child interaction or attachment problems
- Lack of social support for parent
- Severe family stress
- Child abuse or neglect
- Slowed growth in a young child, including height and weight
- Slowed development, including late rolling, sitting, crawling, standing, walking, and talking
- Small muscles
- Weakness, low energy
- Hair loss
- Loose folds of skin
- Other symptoms related to an underlying medical condition
- 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
Treating a Medical Condition
Providing Extra Calories
- Take your children to the doctor regularly to have their growth checked. This helps detect and treat failure-to-thrive before it becomes severe.
- Develop a good relationship with your child's doctor.
- Ask the doctor about proper parenting and nutrition for early in a baby's life.
American Academy of Family Physicians http://familydoctor.org
American Academy of Pediatrics http://www.healthychildren.org
About Kids Health http://www.aboutkidshealth.ca
Public Health Agency of Canada http://www.phac-aspc.gc.ca
Failure to thrive. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/growth/growth/failure%5Fthrive.html . Updated August 2011. Accessed August 20, 2013.
Failure to thrive in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated May 30, 2013. Accessed August 20, 2013.
Krugman S, Dubowitz H. Failure to thrive. Am Fam Physician. 2003 Sep 1;68(5):879-884.
Needlman, R. Failure to thrive: parental neglect or well-meaning ignorance? Am Fam Physician. 2001;63(9):1867-1869.
8/7/2013 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Bocca-Tjeertes IF, van Buuren S, Bos AF, et al. Growth of preterm and full-term children aged 0-4 years: integrating median growth and variability in growth charts. J Pediatr. 2012 Sep;161(3):460-65.
- Reviewer: Kari Kassir, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -