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What Does "Failure To Thrive" Mean?

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Updated March 28, 2009

Question: What Does "Failure To Thrive" Mean?

Regardless of how a baby is fed, birth weight typically doubles in 4 months and triples by the age of 1 year. Breastfed babies should be back to their birth weight in 2 to 3 weeks, but when feeding well, most regain before that period. It is normal for babies to lose weight in the hospital. If the mom received intravenous fluids during labor, the baby may lose more than the average. It is important to keep in mind that "normal" growth is individual with heredity and genetics playing a large part. Infants growth patterns vary, but well-child visits to the pediatrician are essential to assess any potential issues.

Answer:

Different than slow weight gain, failure to thrive, or FTT, is a much more daunting diagnosis -- the word "slow" changes over to "poor" -- and it is very scary for parents to hear. It is difficult to give an exact definition of failure to thrive because, in truth, there has yet to be one that is universally accepted. However, The American Academy of Pediatrics classifies FTT by:

  • Inadequate nutrition variation
  • Inadequate nutrition intake problem
  • Feeding disorder of infancy and early childhood

Further criteria from the National Center of Health Statistics includes:

  • A child younger than 2 years old whose weight is below the 3rd or 5th percentile for age on more than one occasion
  • A child younger than 2 years old whose weight is less than 80% of the ideal weight for age
  • A child younger than 2 years old whose weight crosses two major percentiles downward on a standardized growth chart

If your child falls into any of these categories, be sure that you are giving the treating doctors accurate details on your prenatal and feeding history. This is significant information for them to have. Only 18% of FTT babies stem from organic reasons, but this must be ruled out before attempting further intervention.

Failure to thrive is a very complicated problem which may affect the long-term health and development of the child. This is a very upsetting and guilt-ridden time for the family and a great amount of support is needed. It probably goes without saying that feeding the baby is of utmost importance, and it is necessary that a team of professionals -- doctor, nurse, social worker, dietician, and psychologist -- be involved. It is also recommended that a lactation consultant be involved in the care plan. She will observe:

  • The baby's suckling and/or whether or not he's willing to do so
  • Your comfort
  • Your body position
  • The baby's body position
  • Eye contact
  • Verbalization with the baby
  • Length of time of a feeding
  • Swallowing pattern
She may also recommend that you weigh the baby every day at the same exact time and keep proper records of how much the baby is taking in and how often he is wetting or soiling diapers.

Source:

Pediatrics in Review. 1997;18:371-378.

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