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Failure To Thrive in Infants and Young Children

Posted Oct 02 2010 6:38pm

Recently I dealt with a mother and her infant who was on the verge of being diagnosed with failure to thrive. Just as the phrase implies, failure to thrive, is a condition in which infants (or children) are not growing and developing as anticipated or would be expected. Many times the indicator for a diagnosis of failure to thrive is an infant’s inability to gain weight or failure to gain weight. My own daughter experienced this. From age six months to one year, she dropped 60% on the growth chart, which is of course alarming given that she was unable to walk, crawl, or even sit up. In other words, her drop in the weight growth chart was not due to expending calories or increased activity. This is a very frightening and scary situation. You simply don’t expect to have difficulty feeding your baby or your child. There are some things that parents can do to interrupt this path.

One of the most important things a parent of a failure to thrive child or infant can do is make sure they have a really good physician. It is important that you work with a medical professional to rule out medical conditions that would be the cause of the failure to thrive. For some children (usually not infants), the source could be celiac disease, which a pediatrician could rule out through testing for celiac disease. Much beyond celiac disease, there are other medical conditions, which could be the source or cause of a lack of weight gain. When my daughter dropped 60% in the growth charts, I worked with the pediatrician to do some blood tests that would rule out other medical conditions. Finding none, I was more or less on my own. What we discovered with Anne was that she would lose 2 ounces a day when she was fed foods that “didn’t agree with her” for lack of better terminology. She was not highly allergic to those foods, but they seemed to cause a sufficient disruption in her GI system to cause weight loss. It normally took us two days to get those two ounces back on her.

Now, two ounces is not much – I would agree. However, with a failure to thrive infant or child, it could be the difference between making progress or hospitalization. We used a high-tech baby scale with two of my three children who had feeding issues. One of the best ways to put weight on – the very thing that is called for with failure to thrive infants and children – is to use carbohydrates. With infants, this could be in the form of baby rice cereal or pureed pasta in broth. With older children who have teeth and more chewing capacities, this could come in the form of very fine pasta in broth or pureed pasta in broth as well as higher calorie baked muffins and breads.

In addition to choosing higher calorie foods, another strategy that can help these infants and children is feeding them more often. With my daughter, we feed her non-stop. I wish I was kidding. While she was playing we would feed her – while we were on a walk – we would feed her. Adding a few more snacks typically helps these children.

It is important to have the medical supervision and support to make sure that the nutrition is on track and that any underlying medical causes can be determined or ruled out. It can be extremely frightening and unnerving for a parent with a failure to thrive child. Take heart and comfort in knowing that help is available. Let me know how I can support you if you are dealing with a failure to thrive infant or child. This mother, by the way, reported back that her baby had gained 4 ounces by the hospital visit – a full two ounces over the minimum required – and had gained more weight in one week than in the previous several months. Yay Mom!



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