Incidence of refeeding syndrome is high, with one prospective cohort study showing 34% of ICU experienced hypophosphatemia soon after feeding was restarted. Low resourced settings
Community-based management of malnutrition (CMAM) has been shown to be effective in many low resourced regions in the past two decades. This method includes providing children with ready-to-use therapeutic food (RUTF) and then following up with their health at home or at local health centers. RUTF is readily-consumed, shelf-stable food that provides all the nutrients required for recovery. It comes in different formulations, is generally a soft, semisolid paste, and can be sourced locally, commercially, or from agencies like UNICEF. In terms of efficacy, clinical experience and systemic reviews have shown higher recovery rates using CMAM than previous methods, such as milk-based formulas. While this is an efficient outpatient method to address FTT, children with underlying pathologies would require further inpatient workup.RUTF should be treated as prescribed medication to the child experience FTT, and thus should not be shared with others in the family. The recommended feeding protocol is 5-6 servings a day for about 6–8 months, at which time many children will fully recover. Children should have a follow up every week or two looking at weight and upper arm circumference. Follow ups can be decreased if there is progress without complications, but if the child is not improving, then further evaluation for underlying issues is recommended.
Failure to thrive (FTT), also known as weight faltering or faltering growth, indicates insufficient weight gain or absence of appropriate physical growth in children. FTT is usually defined in terms of weight, and can be evaluated either by a low weight for the childs age, or by a low rate of increase in the weight.The term "failure to thrive" has been used in different ways, as there is no objective standard or universally accepted definition for when to diagnose FTT. One definition describes FTT as a fall in one or more weight centile spaces on a World Health Organization (WHO) growth chart depending on birth weight or when weight is below the 2nd percentile of weight for age irrespective of birth weight. Another definition of FTT is a weight for age that is consistently below the 5th percentile or weight for age that falls by at least two major percentile lines on a growth chart. While weight loss after birth is normal and most babies return to their birth weight by three weeks of age, clinical assessment for FTT is recommended for babies who lose more than 10% of their birth weight or do not return to their birth weight after three weeks. Failure to thrive is not a specific disease, but a sign of inadequate nutrition.In veterinary medicine, FTT is also referred to as ill-thrift.