"Failure to thrive" means that your child is not A growing as well as would be expected. There can be a variety of reasons for this.
How Do You Know If Your Baby Is Failing to Thrive?
Babies who are failing to thrive have growth problems over time. This usually is picked up at well-baby visits to the pediatrician, when your baby is weighed and measured. The weight and length are recorded on a growth chart that compares your baby's size to that of others the same age. If your baby stops growing, grows marginally, or loses weight, the doctor will become concerned.
The pattern of growth over time is more important than individual measurements. For example, some babies may be in the "fifth percentile" for height and weight on the growth chart, meaning that 95% of all babies of the same age are bigger than they are. If, at age 2, these children still rank in the fifth percentile, there is no cause for concern. Some babies are just small, perhaps because their parents are small, or because they were born early.
But if a baby has been in the 90th percentile for weight and height (meaning only 10% of babies the same age are bigger) but suddenly loses weight and drops to the 50th percentile, further investigation is warranted. This may indicate failure to thrive.Unbalanced body proportion can be another indication of failure to thrive. For example, if a baby is at the 95th percentile for height and only the fifth percentile for weight, there may be a problem.
Why Would a Baby Fail to Thrive?
Some babies fail to grow because of repeated or chronic illnesses such as diarrhea, pneumonia, or cerebral palsy. These children have organic failure to thrive, which means that there is a physical cause. Other children have nonorganic failure to thrive because they are not getting enough to eat. Sometimes this is due to power struggles with the person feeding them, in which the child refuses to eat.
Why Is Your Baby Failing to Thrive?
Your baby's doctor will discuss this problem with you and take a careful history. What is your baby eating and drinking each day? When did you notice your baby starting to have growth problems? Does your baby have problems with spitting up? With diarrhea? With breathing? With sleeping? What are mealtime interactions like? Are there struggles over eating? Do you feel you have to push your child to eat? Answering these questions may help you and the doctor begin to understand your child's failure to grow and indicate how to overcome the problem.
What Can Be Done?
Depending on the cause, different recommendations will be made.
If the doctor suspects a physical cause for the growth difficulty, special medical tests may be recommended and treatment required to resolve the problem.
Or the solution could turn out to be as simple as switching to a different infant formula because the baby is allergic to the formula being used. In some cases, failure to thrive is related to coordination, sucking, and swallowing problems. In this case, the doctor may recommend consultation with a feeding specialist or an occupational or speech therapist who can help you improve your baby's eating skills.
In those situations where mealtimes have turned into power struggles between feeder and child, a psychologist may be able to provide useful ideas and insights into your child's eating behaviors
Sometimes no medical problem can be found and you have tried to add calories to the baby's diet, but growth still does not happen. In these cases, hospitalization may be necessary. In the hospital, the baby can be observed and charted 24 hours a day to see what is eaten and when, and any necessary medical tests can be performed.
Children with Disabilities
Children with special needs are more likely to have growth problems. Caring for a baby with developmental disabilities is hard enough, and growth problems only increase your stress. Get help. Communicate regularly with your team of medical, feeding, nutrition, and therapy specialists. These and other professionals usually are quite familiar with the growth difficulties of children with special needs and will work with you to find the cause and help your child grow.
Reference
Newmark, S. 1990. Failure to thrive; Parent articles for early intervention. Tucson. AZ: Therapy Skill Builders.
