Failure to thrive refers to abnormally slow growth in infants and young chil dren. In general, it describes a child under two years of age who weighs less than 80 percent of the average for children with the same birth weight. The child may also lag in other aspects of development, including speech and motor control. The cause might be organic or non-organic, but more often it is a mixture of the two. The most obvious and common organic cause is severe malnutrition; however, failure to thrive may afflict an adequately fed child who has a congenital defect or a disease that interferes with eating and metabolism. The condition is considered non-organic when no physical abnormality can be found to account for it. An example would be a baby who is healthy at birth and perhaps even does well initially, but then regresses. The mother (or primary caregiver) and the family environment playa critical role in non-organic failure to thrive. Often, poor parenting skills are at fault. A depressed mother may fail to bond with her baby, or parents may fear spoiling a child by responding to crying. Social and economic circumstances also play a role; there simply may not be enough time or money to provide for a baby’s needs. Regardless of the cause, the consequences can be serious if the child continues not to gain weight. Without adequate nutrition, intellectual development may be stunted, and the child may even die.
Diagnostic Studies And Procedures
The first step involves trying to identify organic causes. The physician will ask the parents about any symptoms, previous illnesses, and family history of genetic diseases, also the baby’s feeding habits. She might inquire about some aspects of the mother’s pregnancy her diet and whether she smoked or used drugs or alcohol. The baby will then be examined. In diagnosing failure to thrive, a doctor uses established medical standards for weight, height, head circumference, hand size, and skeletal development. He may test the child’s hearing and vision and also order blood, urine, and X-ray studies. If there appear to be no organic abnormalities, the doctor usually concentrates on identifying psychological factors that could be contributing to the baby’s delayed development. He asks the parents to describe the home environment and observes the interaction between the mother and her baby. Looking for signs of emotional deprivation or inadequate attachment, the physician notes whether or not the baby makes eye contact with the mother, responds to being held and spoken to, and takes any interest in the surroundings. Typically, a child who fails to thrive is listless and withdrawn, and does not respond to cuddling and other stimuli. The youngster may engage in repetitive motions, such as banging its head or rocking back and forth.
Any underlying medical problem an illness or congenital defect-must be treated. A severely malnourished child may be hospitalized for special feeding, possibly including intravenous fluids and nutrients.
Successful treatment often necessitates a team effort by health professionals and alternative practitioners.
Parents who need to improve their relationship with an unusually demanding baby may require special therapy. A social worker or family therapist might make a home visit to study family dynamics and suggest ways to improve the relationships between the parents and between each parent and the child.
A diet that provides the protein and calories needed for proper growth and development is critical in overcoming failure to thrive. Consulting a nutritionist experienced in treating infant feeding problems may be necessary to make sure that the baby’s diet is sufficient. Often, a listless, malnourished child lacks appetite and must be encouraged to eat frequent, calorie enriched meals. If finances are a factor, the nutritionist can help the parents to enroll in assistance programs and can instruct them in how to provide nourishing foods at low cost.
Physical and Occupational Therapy
Professionals in these specialties can guide parents in setting up stimulating activities to foster the child’s emotional and intellectual development.
If failure to thrive is rooted in the parent child relationship, joining a self help group composed of parents with similar problems can be a source of support and understanding.
Other Causes of Retarded Growth
Cystic fibrosis, malabsorption disorders, esophageal disorders, anemia, thyroid disorders, congenital heart defects and other anomalies, and HIV and other infections are among the many organic conditions that may account for a baby’s failure to thrive.