- Is at or below the third to fifth percentile for height and weight.
- Has failed to grow as expected. This is shown by crossing two percentile lines on the growth chart.
- Organic—caused by some medical condition
- Nonorganic—occurs in children with no known medical condition
- Mixed—occurs when the child has features of both
- Inadequate food intake
- Malabsorption—inability of the intestines to properly absorb nutrients from food
- Loss of nutrients, which may occur from excessive vomiting or diarrhea
- Inability to process nutrients correctly
- Increased energy expenditure
- Genetic disorders, such as cystic fibrosis, Down Syndrome, or Turner syndrome
- Physical defects, such as cleft lip or palate which interfere with feeding
- Gastrointestinal diseases, such as:
- Chronic or untreated urinary tract infections
- Kidney failure
- Undiagnosed food intolerance
- Heart and lung diseases, such as:
- Endocrine diseases, such as diabetes, or thyroid or pituitary gland disorders
- Chronic or congenital infectious diseases such as HIV or toxoplasmosis
- Fetal alcohol syndrome
- Lead poisoning
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- Reduced availability of food
- Giving non-nutritious foods
- Withholding food
- Breastfeeding difficulties
- Depression in the parent
- Lack of knowledge about proper nutrition and typical child growth patterns
- Parent and child interaction or attachment problems
- Lack of social support for the parent(s)
- Severe family stress
- Child abuse or neglect
- Slowed growth in a young child, including height and weight
- Slowed development, including late rolling, sitting, crawling, standing, walking, and talking
- Small muscles
- Weakness, low energy
- Hair loss
- Loose folds of skin
- Other symptoms related to an underlying medical condition
- Monitor the relationship between parent and child, paying particular attention to their behavior around feeding
- Set up a feeding schedule with an adequate amount of calories
- Make sure that an appropriate feeding technique is used
Treating a Medical Condition
Providing Extra Calories
- Take your children to the doctor regularly to have their growth checked. This helps detect and treat failure-to-thrive before it becomes severe.
- Develop a good relationship with your child's doctor.
- Ask the doctor about proper parenting and nutrition for early in a baby's life.
FamilyDoctor.org—American Academy of Family Physicians http://familydoctor.org
Healthychildren.org—American Academy of Pediatrics http://www.healthychildren.org
About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca
Public Health Agency of Canada http://www.phac-aspc.gc.ca
Failure to thrive. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/growth/growth/failure%5Fthrive.html. Updated August 2011. Accessed September 24, 2014.
Failure to thrive in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated August 5, 2013. Accessed September 24, 2014.
Krugman S, Dubowitz H. Failure to thrive. Am Fam Physician. 2003 Sep 1;68(5):879-884.
Needlman, R. Failure to thrive: parental neglect or well-meaning ignorance? Am Fam Physician. 2001;63(9):1867-1869.
8/7/2013 DynaMed's Systematic Literature Surveillance. https://dynamed.ebscohost.com/about/about-us: Bocca-Tjeertes IF, van Buuren S, et al. Growth of preterm and full-term children aged 0-4 years: integrating median growth and variability in growth charts. J Pediatr. 2012 Sep;161(3):460-465.
- Reviewer: Kari Kassir, MD
- Review Date: 08/2014 -
- Update Date: 09/24/2014 -