What Causes Failure To Thrive?

Conditions list medically reviewed by George Krucik, MD, MBA

A child is said to have failure to thrive when they don’t meet recognized standards of growth. According to Kids Health, failure to thrive isn’t a disease or disorder. Instead, it describes a situation in which a child is undernourished and either... Read More

A child is said to have failure to thrive when they don’t meet recognized standards of growth. According to Kids Health, failure to thrive isn’t a disease or disorder. Instead, it describes a situation in which a child is undernourished and either doesn’t receive or is unable to process enough calories. An example of failure to thrive (FTT) would be a child who is persistently below the standard weight range for their developmental stage. Typically, a doctor will diagnose failure to thrive during a child’s infant years.

A doctor determines a child’s ideal weight by comparing their weight, age, and gender to national averages. Children who fail to thrive usually fall well below their ideal weight. A child may also be diagnosed with FTT if their growth rate in terms of height stalls when it should be on an upward trend.

Ask your doctor for a chart that lists ideal height and weight ranges for children to help monitor your child’s development. The U.S. Centers for Disease Control and Prevention (CDC) also offer a chart that you can use as a reference.

Risk factors

Risk factors for a child failing to thrive include underlying conditions, such as:

  • Down syndrome
  • cerebral palsy
  • heart disease
  • infections
  • milk allergy
  • cystic fibrosis
  • celiac disease
  • acid reflux

Children who have serious medical problems during the early years of their life can develop FTT. Children who are born prematurely and have low birth weight may also fail to thrive.

Other risk factors include:

  • poor nutrition
  • poor feeding habits
  • neglect
  • physical abuse
  • mental trauma
  • mental disorders, such as depression
  • environmental factors, such as poverty

What are the symptoms of failure to thrive?

Generally, an affected child’s weight falls below the 3rd percentile on standard growth charts. A change in the rate of growth, rather than specific numbers, is also an indicator. For example, if your child has been growing well, but their growth stagnates, they may have FTT.

Your child may have an unsteady rate of growth. Some children who fail to thrive exhibit the following symptoms:

  • lack of weight gain
  • delays in reaching developmental milestones such as rolling over, crawling, and talking
  • learning disabilities
  • lack of emotions such as smiling, laughing, or making eye contact
  • delayed motor development
  • fatigue
  • irritability
  • delayed puberty in teens

When should I seek medical treatment?

Regular checkups can prevent failure to thrive. These should begin during your pregnancy and continue through adulthood. Your doctor should regularly plot your child’s growth on growth charts.

A child with FTT may be small compared to other children of the same age and gender. Their growth pattern may not be steady. Have regular checkups with a pediatrician to get the most accurate analysis of your child’s growth.

Because failure to thrive can lead to permanent mental, emotional, and physical delays, it’s important to have regular checkups so that doctors can monitor your child’s health.

How is failure to thrive diagnosed?

Tests can assess the effects of FTT on your child’s health and growth. These may include:

  • blood tests
  • urine tests
  • X-rays
  • developmental screenings

Caregivers may need counseling if the doctor suspects that unhealthy practices in the family are a cause.

What are the treatment options for failure to thrive?

Treatment options vary depending on:

  • the severity of symptoms
  • the overall health of the child
  • the preferences of parents or caretakers
  • the family environment
  • the cause of condition

Some cases of failure to thrive may be resolvable once a doctor treats the underlying condition. If FTT requires further care, the child’s doctor may prescribe nutritional supplements or a special diet.

When FTT has a connection to problems at home, your doctor may consult social services. Hospital care, including the use of feeding tubes, can provide extra nourishment in cases of severe FTT.

After your child’s growth has reached normal levels, they may need help to keep physical and mental growth on track. Physical therapists, speech therapists, occupational therapists, dietitians, and other specialists may be able to help your child.

What is the long-term outlook?

If your child receives treatment for FTT early, they should be able to grow normally, barring any serious medical issues. Failure to thrive that’s not treated can result in long-term complications, including learning disabilities, emotional problems, and short stature.

If you notice that your child is having difficulty eating, consult your doctor right away. If you become frustrated and begin to feel stress, your child may perceive your feelings and feel more anxiety about eating. Talking to a doctor early on can alleviate your fears and get your child on the road to proper health and nutrition.

Medically reviewed by Graham Rogers, MD on January 27, 2017Written by Marissa Selner


7 possible conditions

This feature is for informational purposes only and should not be used to diagnose. Please consult a healthcare professional if you have health concerns.

Conditions list medically reviewed by George Krucik, MD, MBA