Endocrinology Book

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Failure to Thrive Management

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  1. See Also
    1. Failure to Thrive
    2. Failure to Thrive Causes
    3. Failure to Thrive Evaluation
  2. Management: Calories required for catch-up
    1. Children with FTT require 150% of RDA of calories
    2. Schedule: Replacement calories needed per day
      1. Kg based on expected weight
      2. Age 2-4 weeks: 120 KCal/kg/day
      3. Age 1-2 months: 115 KCal/kg/day
      4. Age 2-3 months: 105 KCal/kg/day
      5. Age 3-6 months: 95 KCal/kg/day
      6. Age 6 months to 5 years: 90 KCal/kg/day
    3. Formula: Replacement calories needed per day
      1. KCals/kg = (120 kcal/kg x (Normal kg)) / (current kg)
  3. Management: Dietary
    1. Stop solids less in calories/ounce than formula, milk
    2. Limit fruit juice to <8 ounces per day
    3. Supplement foods with high caloric value
      1. PediaSure
      2. Add rice cereal, cheese, peanut butter to foods
    4. Daily multivitamin
  4. Management: Behavioral
    1. Involve parents actively in evaluation and management
      1. Helps with frustration and guilt of Failure to Thrive
    2. Restore adequate caretaking
    3. Modify maladaptive learned feeding responses
      1. Behavioral and Family Treatment
    4. Address interactional difficulties with parents
    5. Consider Psychiatric and Social Services
    6. Developmental Stimulation
      1. Community infant-stimulation programs
  5. Monitoring
    1. Close, weekly pediatric follow-up
  6. References
    1. Bauchner in Behrman (2000) Nelson Pediatrics, p. 120-1
    2. Krugman (2003) Am Fam Physician :
    3. Maggioni (1995) Pediatr Clin North Am 42(4):791

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