Failure to Thrive

Failure to thrive is a term that refers to inadequate growth of the child due to the inability to ob­tain or use essential nutrients. Failure to thrive may be organic or nonorganic. Organic failure to thrive is the re­sult of a physiologic cause that prevents the infant from obtaining or using nutrients appropriately. An example of organic failure to thrive is inadequate growth of an infant with deficient energy reserve because of a con­genital defect that makes sucking and feeding difficult. Nonorganic failure to thrive is the result of psychological factors that prevent adequate intake of nutrition. An exam­ple of nonorganic failure to thrive is inadequate weight gain due to inadequate intake of nutrients because of parental neglect.

Diagnosis of the type of failure to thrive depends on careful examination and history of the infant and follow-up evaluations. An individual infant's growth can be compared with the standards for normal growth and de­velopment. Cases of organic failure to thrive usually are easier to diagnose than cases of nonorganic failure to thrive. Diagnosis of nonorganic failure to thrive requires extensive investigation of history, family situation, rela­tionship of the care provider to the infant, and evalua­tion of feeding practices. The nonorganic basis should be considered early in every case of failure to thrive.

Therapy for failure to thrive depends on the cause. Because long-term nutritional deficiencies can result in impaired physical and intellectual growth, provision of optimal nutrition is essential. Methods to increase nutri­tional intake by adjusting caloric density of the formula or by parenteral nutrition may be required in cases of organic failure to thrive.