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.
If no cause is discovered, a stool examination could be indicated, which would give information about the function of gastrointestinal organs. C-reactive protein and erythrocyte sedimentation rate (ESR) can also be used look for signs of inflammation, which may indicate an infection or inflammatory disorder. Treatment
Infants and children who have had unpleasant eating experiences (e.g. acid reflux or food intolerance) may be reluctant to eat their meals. Additionally, force feeding an infant or child can discourage proper self-feeding practices and in-turn cause undue stress on both the child and their parents. Psychosocial interventions can be targeted at encouraging the child to feed themselves during meals. Also, making mealtimes a positive, enjoyable experience through the use of positive reinforcement may improve eating habits in children who present with FTT. If behavioral issues persist and are affecting nutritional habits in children with FTT it is recommended that the child see a psychologist. If an underlying condition, such as inflammatory bowel disease, is identified as the cause of the childs failure to thrive then treatment is directed towards the underlying condition. Special care should be taken to avoid refeeding syndrome when initiating feeds in a malnourished patient. Refeeding syndrome is caused by a shift in fluid and electrolytes in a malnourished person as they receive artificial refeeding. It is potentially fatal, and can occur whether receiving enteral or parenteral nutrition. The most serious and common electrolyte abnormality is hypophosphatemia, although sodium abnormalities are common as well. It can also cause changes in glucose, protein, and fat metabolism.