Failure to Thrive is a term that is applied to children whose current weight or rate of weight gain is significantly below that of other children of similar age and gender. Infants or children that fail to thrive seem to be smaller or shorter than other children the same age. Teenagers may have short stature or appear to lack the usual changes that occur at puberty.

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, it may lead to permanent brain damage and developmental delays, as well as behavior problems, short stature and immunity problems.

Failure to Thrive is due to inadequate nutrition for normal growth and development. It is important to determine whether it is caused by medical problems or factors in the environment, such as abuse or neglect, although there are times that the cause cannot be determined.

Medical causes of failure to thrive include:

• Heart or lung problems, which can affect how oxygen and nutrients move through the body
• Digestive problems due to poor absorption or a lack of digestive enzymes
• Problems with hormones that affect growth, such as thyroid hormone deficiency
• Metabolic disorders which affect how the body turns food into energy
• Damage to the brain or central nervous system, which may cause feeding difficulties in an infant

Environmental or psychosocial causes that may lead to failure to thrive are:

• Emotional deprivation as a result of parental depression or rejection
• Economic problems that affect nutrition, living conditions, and parental attitudes
• Poor eating habits, such as eating in front of the TV and not having structured meal times.
• Other factors such as social isolation, substance abuse, violence and abuse.

• Height or weight does not match the standard growth charts for the child’s age and gender.
• The child’s weight is lower than the 3rd percentile or 20% below the ideal weight for the child’s height.
• Growing that has slowed or stopped after having previously achieved a stable pattern of growth.
• Delayed developmental milestones such as rolling over, sitting, standing and walking.

The treatment depends on the cause of the Failure to Thrive. The healthcare provider will do a physical exam, check the height and weight and take a detailed history (including prenatal, birth, neonatal, psychosocial and family information). They may do blood tests; x-rays to determine bone age, testing of stools, a dietary history or developmental and behavioral testing.

The goal of the evaluation is to identify the potential contributing factors so that each one may be addressed. Often there is a team approach to treatment with the involvement of a dietician, occupational or speech therapist, social worker, behavioral or developmental pediatrician and Early Intervention services in the home.

In severe cases of Failure to Thrive, a child may be hospitalized to implement a comprehensive medical, behavioral and psychosocial treatment plan.