What Is Failure To Thrive In Newborns

Treatment Of Failure To Thrive In Infants

Baby Your Baby Failure to Thrive

Nutritional rehabilitation is the main concern of the treatment. It should be emphasized that immediate management of acute problems such as dehydration, shock, and others must first be addressed.

Seeking early help with FTT childs nutritional needs is a vital move to avoid worsening the condition. Apart from immediate management of acute problems, the nursing care planning and goals for children with Failure to thrive are the following:

  • Achievement of ideal weight for height and correction of nutritional deficiencies
  • Allowance for catch up growth
  • Optimum body composition restoration
  • Parental awareness in child feeding and nutritional requirement.

How Is Failure To Thrive Diagnosed

Failure to thrive is usually discovered and diagnosed by the infant’s physician. Infants are always weighed and measured when seen by their physicians for well-baby check-ups. The physician initiates a more complete evaluation when the infant’s growth, development, and functioning are found to be delayed.

What Is Failure To Thrive In Children

Failure to thrive in children is a blanket term that medical experts use to indicate poor growth in an infant, toddler, or child. A medical problem or feeding issue can lead to a child’s failure to thrive. A child’s healthcare provider monitors their growth through every age to catch this medical problem as early as possible, as it can lead to developmental delay, behavior problems, or physical problems later in life.

Failure to thrive is generally categorized as nonorganic failure to thrive or organic failure to thrive. An organic cause is a medically diagnosable issue that causes a child not to eat or absorb nutrients properly. In contrast, nonorganic FTT has non-medical causes, such as inadequate nutrition or child abuse or neglect.

FTT is on the list of child disabilities that could be eligible for Supplemental Security Income . The SSA accepts FTT with or without a known cause if the child’s pediatrician documents low birth weight, poor weight gain, or delayed overall growth for their age.

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Symptoms Of Failure To Thrive

Its important for all parents to recognize the symptoms of a baby who is failing to thrive. Seeking help early on will prevent a lot of suffering for the baby while minimizing the risk of permanent damage to the developing brain and other organs. Fast intervention can also help parents take control of the situation, relieving a lot of stress and anxiety.

The following list is a good example of what you may notice if your child isnt growing at the expected rate:

  • Unexplained fussiness or crying
  • Lack of vocalization
  • Avoiding eye contact

Some parents may realize that their baby isnt as pudgy as they once were, but they may assume that the baby is growing longer and thinning out as a natural part of the growth process. Its also commonly assumed that an under- or malnourished baby will cry a lot and show signs of distress, but research has shown that some babies seem perfectly content even when they arent receiving adequate nutrition.

Some babies may show signs of failure to thrive as an infant while others may start out healthy and later start to lose weight. If you know that your baby isnt as active, alert or reactive as they once were, its worth a trip to the doctor for a checkup.

You may also notice that your baby seems happy and satisfied with feedings but is losing weight. In that case, it doesnt hurt to have a doctor check your babys growth rate. Its always better to seek too much attention than to delay the attention that your baby needs.

Physical Or Organic Causes

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There are a few reasons why FTT can happen. Sometimes theres a physical or organic reason which causes the baby not to absorb or metabolise nutrients. This means they are unable to use the food theyre eating to fuel their growth.

Common medical conditions causing FTT include:

  • conditions which demand more energy cardiac problems, respiratory issues, infection or hormone disorders

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What Happens If My Baby Has Failure To Thrive

Your baby will need to be examined by a paediatrician. Sometimes more frequent breast or formula feeds and for babies over 6 months, increased solids, are enough to provide extra kilojoules to support increased growth. If FTT is not related to feeding or an underlying disease, medical practitioners can investigate further.

Regular weight and growth checks are important for babies who are diagnosed as having FTT. Check with your child health nurse, doctor and paediatrician to monitor your babys growth.

What Causes Cerebral Palsy

The cause of CP isnt always known. But many cases happen when a childs brain is still developing, such as before birth or in early infancy. This may be due to:

  • infections or other medical problems during a womans pregnancy
  • a stroke either in the womb or after birth
  • genetic disorders

In rare cases, CP happens because something goes wrong during a childs birth.

Premature babies have a higher chance of having CP than full-term babies. So do other low-birthweight babies and multiple births, such as twins and triplets.

Areas of the brain that affect learning can also be affected. This can lead to learning disabilities. Brain damage also can happen from:

  • being shaken as an infant
  • an injury from an accident

In rare cases, CP happens after a problem during childbirth.

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Low Or No Weight Gain

Perhaps the most common symptom of FTT is not gaining enough weight. Pediatricians use growth charts for specific age ranges to monitor a child’s weight at every check-up.

Children at risk for FTT based on slowed weight gain may have more frequent check-ups than those who meet the benchmarks for their age. A child who isn’t gaining enough weight, especially during the first crucial months of infancy when weight gains rapidly, may have inadequate caloric intake or another feeding issue that signals FTT.

What If Theres No Apparent Cause For Failure To Thrive

Recognizing a Baby’s Failure to Thrive | Infant Care

Its not always clear what causes a baby to fail to thrive and sometimes no specific cause is found. This makes it difficult for parents who may feel theyre doing all they can to feed their baby regularly and support them to grow.

Its not uncommon for parents to feel stressed and anxious about their babys growth, especially when their baby is diagnosed with FTT. Just as a parents emotional distress can contribute to FTT, parental anxiety is a common outcome when a baby does not grow as they need to.

However, some babies are smaller because of genetics. Parents who are shorter and smaller than average are more likely to have children with the same characteristics.

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The Baby Isnt Getting Enough Calories

The reason for a babys poor growth might be due to a lack of calories. This might be from a problem with feeding, but it can also be because of a problem with digestion.

Reasons for poor feeding include:

  • The baby isnt being fed often enough.

  • The baby isnt getting enough food at each feeding.

  • The baby has difficulty sucking on a nipple, possibly due to prematurity or muscle weakness.

  • The baby has gastroesophageal reflux or frequent vomiting.

  • The baby has malformations of the mouth or throat, like a cleft lip or palate.

  • The formula hasnt been mixed properly .

  • The baby is filling up on water, juice, low-fat milk, or an alternative formula that doesnt contain the right nutrition.

  • The nursing parent is not making enough milk for the babys needs.

If the baby is feeding well but is having trouble with digestion, their body cant use the calories they eat.

Here are some reasons a baby may have problems with digestion:

How We Diagnose Failure To Thrive

It takes a village to diagnose, treat, and manage the health of children with FTT. So, the first step in diagnosing FTT is to have a thorough conversation with you about the child’s symptoms and history.

At the first appointment, the doctor will ask what flagged your concern and when you first noticed symptoms. The doctor will also ask about your child’s medical history to look for issues that might cause poor feeding or trouble absorbing nutrients.

Specifically, the doctor will ask about:

  • Bowel and urination habits
  • Emotional, social, or mental challenges
  • Stalled growth or physical development
  • Home environment, such as access to food, safety, and risk of exposure to toxins
  • Other health conditions, such as diabetes, gastrointestinal issues, or known food allergies

The doctor will also check the child’s general health and compare their measurements to standard growth chart milestones for:

  • Head circumference

The standard weight indicator for FTT is when a child consistently falls below the fifth percentile for age- and sex-appropriate weight or loses so much weight in a short period of time that they dip below two major percentile lines on a standard growth chart.

Depending on the child’s condition, the doctor might also recommend other testing to check for infections or underlying conditions. This might include blood or urine tests or imaging such as X-rays.

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Failure To Thrive Diagnosis And Treatment

Your doctor assesses your child for potential causes of failure to thrive so that they can treat the underlying concern.â

Health problems. If a medical problem is to blame, your doctor wants to diagnose the health condition so that your child can receive appropriate treatment. Approaches used for treating failure to thrive may include: â

  • physical therapy
  • assistance from a dietician
  • a feeding tube if an inability to eat and drink is a factorâ

Environmental concerns. Your doctor may also ask about your home life to pinpoint any environmental factors that contribute. These might include your familyâs eating habits and mealtimes and your childâs routine. It is important to determine whether failure to thrive results from medical problems or factors in the environment such as abuse or neglect.â

Common environmental factors include:â

  • a lack of emotional support and love from a caregiver or parent
  • rejection or hostility from a caregiver or parent
  • inadequate food and unsuitable living conditions
  • infections, parasites, or toxinsâ
  • poor eating habitsâ

If environmental factors are contributing to failure to thrive, your doctor may provide educational materials to help you with making lifestyle changes.â

It may take some trial and error to come up with a solution that helps your child with their specific needs. In some cases, your child may need to be hospitalized for monitoring prior to more comprehensive treatment.â

Behavior Or Learning Problems In Older Children

Failure to thrive

Parents and guardians of children with FTT may notice changing behaviors or learning difficulties from toddlerhood to childhood. Proper nutrition allows children to meet developmental milestones in these areas, whereas malnutrition can delay them, eventually making children fall behind their peers.

Children with FTT may not have typical social tendencies, like playing nicely with others or finding ways to communicate with peers. They also might struggle in school due to problems with memory, staying organized, or paying attention.

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How Is Cystic Fibrosis Diagnosed

Newborn screening tests catch most cases of CF. If the screening test is positive, or if a child has cystic fibrosis symptoms, doctors do a painless sweat test. They collect sweat from an area of skin to see how much chloride is in it. People with CF have higher levels of chloride.

Most children with CF are diagnosed by the time theyre 2 years old. But someone with a mild form may not be diagnosed until they are a teen.

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Failure To Thrive In Infants

Failure to Thrive describes an infant or child who does not gain weight at the expected rate. The two kinds of FTT are organic and non-organic. Medical problems such as diarrhea or vomiting that continue may be the cause of organic FTT. If your child has organic FTT, it could be that he or she is not able to take in nutrients from food or formula. Tests will be done to see if there is a medical problem. Sometimes Failure to Thrive has no medical cause and is called non-organic FTT. Infants with non-organic FTT usually begin to gain weight when changes are made in the way the baby is fed, cared for and nurtured.

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Hope For Children With Ftt

If FTT is diagnosed early, many children can be treated at home with ongoing pediatric care. The pediatrician can watch for changes in the child’s weight and flag any trends that suggest additional needs to address.

Family support at home is key. Children’s Health and UT Southwestern offer family counseling and nutrition education to help improve and maintain the child’s ongoing health.

You want whats best for your child. Raising concerns with your child’s doctor and asking for help when you need it can make a world of difference.

If you’re concerned that your child might have failure to thrive, call or request an appointment online.

Can You Test For Failure To Thrive

Paediatric Physiotherapy – Infant – Failure to Thrive (Orange)

A FTT diagnosis is the beginning of an investigation. Your childs care team will need to gather more information about your child and their medical history. Theyll want to know lots of details about where they live, how they are fed, who lives with them, and the health of other family relatives. Theyll also need to see and examine the baby. And theyll probably ask you to keep a feeding log for a few days.

Depending on the child and the situation, your healthcare provider might run some additional tests, including:

  • X-rays or other imaging studies

In rare cases, they may need to refer the child to a specialist. But most likely, your healthcare provider will request a follow-up appointment to recheck weight and growth.

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How Can Doctors Tell If My Child Isn’t Thriving

Your childs doctor will keep a history of height and weight at each doctor visit. Theyll compare your childs height and weight to:

  • Height and weight recorded on previous doctor visits

  • The usual height and weight for children that age

They suspect failure to thrive if your child isn’t growing as expected. Doctors examine your child and ask about your child’s eating habits and symptoms.

If your child is getting enough food, doctors do tests to figure out if a medical problem is causing failure to thrive. They usually do:

  • Urine and stool tests

What Else Should I Know

Kids with CP often need to see many different medical specialists for care. That team may include doctors and surgeons, other providers like physical assistants, nurses, therapists, psychologists, educators, and social workers.

Even if many medical specialists are needed, its still important to have a primary care provider or a medical home. This provider will take care of your childs routine health care and also help you coordinate care with other doctors.

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Affecting Up To 10% Of All Children Under The Age Of 2 A Failure To Thrive Diagnosis Can Be Scarybut Is It Really We Asked Several Experts To Weigh In

Kimberly Zapata is the Associate Editor at Parents. Her parenting, health, and wellness work has been published on numerous websites, including Health, Healthline, Parade, Washington Post, Huffington Post, Oprah, The Mighty, Mic, and Vice. She is also the founder and creator of Greater Than: Illness, an organization dedicated to empowering teens and young adults struggling with mental illness. And when she is not writingor workingshe is caring for her two children, aged 8 and 3.

Millions of children are diagnosed with failure to thrive, or FTT, each year. According to one study, failure to thrive affects up to 10% of children under the age of 2 in high income countries. But while the word “failure” leaves many parents feeling frightenedwhen my own son was diagnosed with FTT in 2019 I was terrified I felt like a bad parent and didn’t know what to dothe term is just that: a medical term, one use to denote a specific state of being or existence.

But what is FTT, really? Should parents be concerned? Here’s everything you need to know about failure to thrive, from what causes it to how it really affects children.

Diagnosis Of Failure To Thrive

Failure to Thrive
  • Frequent weight monitoring

  • Blood urea nitrogen and serum creatinine and electrolyte levels

  • Urinalysis and culture

  • Stool for pH, reducing substances, odor, color, consistency, and fat content

Depending on prevalence of specific disorders in the community, blood lead level, HIV, or tuberculosis testing may be warranted.

Other tests that are sometimes appropriate include levels of thyroxine and thyroid-stimulating hormone . Growth hormone assessment Diagnosis Growth hormone deficiency is the most common pituitary hormone deficiency in children and can be isolated or accompanied by deficiency of other pituitary hormones. Growth hormone deficiency… read more is appropriate when growth in height is more severely affected than growth in weight or when height/length and weight fall off simultaneously . Additionally, even though newborn screening tests now assess newborns for cystic fibrosis, a sweat test should be done if the child has a history of recurrent upper or lower respiratory tract disease, a ravenous appetite, foul-smelling bulky stools, hepatomegaly, or a family history of cystic fibrosis. Newborn screening test results should be reviewed for indications of other genetic diseases.

Investigation for infectious diseases should be reserved for children with evidence of infection however, a urine culture may be helpful because some children with FTT due to urinary tract infection lack other symptoms and signs.

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