II. Definition

  1. Inadequate weight gain (or Weight Faltering) over time
  2. Malnutrition due to inadequate Caloric Intake or absorption or excessive caloric expendature

III. Epidemiology

  1. Incidence
    1. Hospitalized children <2 years: 1-5%
    2. Families with Medical, Psychosocial problems: 10%

V. Signs

  1. Weight is affected first by Malnutrition
  2. Length and Head Circumference affected in severe cases
  3. Cognition and failure to meet Developmental Milestones may occur in very severe cases

VI. Diagnosis: Failure to Thrive

  1. See Failure to Thrive Diagnosis
  2. Relies on accurately recorded weight and height on growth chart over time
    1. Weight below 5th percentile for gender and Corrected age OR
    2. Weight for Length <5th percentile OR
    3. BMI for age <5th percentile OR
    4. Decreased Growth Velocity with Weight for Length falling by more than 2 major percentile lines

VIII. Management

IX. Prognosis

  1. Nonorganic Failure to Thrive risks poor outcomes
    1. Risk of cognitive delay and school difficulty
      1. Lower Wechsler Intelligence Scale for Children
      2. Poorer language development and reading skills
    2. Social immaturity
      1. More frequent behavior problems
  2. References
    1. Oates (1985) Pediatrics 75:36 [PubMed]

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