Failure to Thrive (FTT) Health Article

Treatment

To diagnose FTT and assess its causes in a child are significant steps towards treating the syndrome. The immediate goal of treatment is to encourage or induce catch-up growth, defined as a growth rate of 2-3 times the average for the child's age. The feeding and/or eating problems that were identified in diagnosis should be corrected, the child's food should be calorically enriched, and a multivitamin given to make up for deficiencies caused by rapid growth. Infant formula may be concentrated up to no more than 24 calories per ounce (one 13 oz. can plus 8 oz. water). For catch-up growth the child should consume between 120-180 calories per kilogram of weight per day. The desired growth should occur within the first month.

More serious cases of FTT may require immediate hospitalization and artificial feeding/nutrition, followed by the usual testing for organic causes, along with an extensive assessment of the child's total caloric intake and eating or feeding circumstances at home. Medical, nutritional, and social factors should all be observed, preferably in their natural settings, by a "grow" team of a doctor, nurse, social worker, nutritionist, and possibly a psychologist.

For cases of FTT caused by parental neglect, mistreatment, or dysfunctional family dynamics, extensive education and/or therapy is required for the parents. Children who experience catch-up growth while being treated may relapse into malnutrition when they return home or intervention services cease. FTT in these cases is not quickly resolved. Studies have found that, even when corrected for race, gender, and socioeconomic factors, statistical figures indicate that children are at high risk for this type of FTT (non-organic) when they come from families where the parents fight or argue, where there are three or more older siblings, and where very low resources are devoted to care for the child (i.e., compared to the spending habits of other families with the same income). Parents of children who suffer from non-organic FTT due to abuse tend to be more unresponsive, disorganized, harsh, and aggressive with their children than other parents of the same race, gender, and socioeconomic status. Whether it is the cause or effect of FTT, infants and children with non-organic FTT caused by abuse tend also to have withdrawn and irritable temperaments.

Books

Drotar, Dennis, ed. New Directions in Failure to Thrive: Implications for Research and Practice. New York: Plenum Press, 1985. Based on the Proceedings of the National Institute of Mental Health Workshop held October 9-10, 1984.

Periodicals

Frank, Deborah A., Robert Needlmen, and Mary Silva. "What to Do When a Child Won't Grow (Treating Failure to Thrive)." Patient Care 28, May 1994, pp. 107-22.

Goldson, E. "Neurological Aspects of Failure to Thrive." De velopmental Medicine and Child Neurology 31, 1989, pp. 821-26.

Phelps, LeAdelle. "Non-Organic Failure to Thrive: Origin and Psychoeducational Implications." School Psychology Review, January 1,1991, pp. 417-29.

Organizations

The MAGIC Foundation for Children's Growth
Address: 1327 N. Harlem Avenue
Oak Park, IL 60302
Telephone: (708) 383-0808
(National non-profit organization providing support services for families of children afflicted with chronic and/or critical disorders, syndromes, and diseases that affect a child's growth.)