Premium Nahrungsergänzungsmittel | artgerecht

Failure to Thrive: Causes, Symptoms and Treatment

Failure to thrive describes inadequate physical growth and insufficient weight gain in infants and young children. It can have organic or non-organic causes and requires early medical evaluation.

Regular tips about health Regular tips about health

Things worth knowing about "Failure to Thrive"

Failure to thrive describes inadequate physical growth and insufficient weight gain in infants and young children. It can have organic or non-organic causes and requires early medical evaluation.

What is Failure to Thrive?

Failure to thrive (FTT) is a term used to describe inadequate physical growth in infants, toddlers, or older children who do not gain weight appropriately or who fall behind age-appropriate developmental norms. The diagnosis is typically based on standardised growth charts, where a child's weight consistently falls below the 3rd percentile or shows a significant downward crossing of two or more major percentile lines.

Failure to thrive is not a disease in itself, but rather a clinical sign that may point to a variety of underlying causes. It most commonly occurs during the first year of life but can affect older children as well.

Causes

The causes of failure to thrive are traditionally divided into two main categories:

Organic Causes

Gastrointestinal disorders: e.g., coeliac disease, Crohn's disease, gastro-oesophageal reflux, cow's milk protein allergy
Congenital heart defects: increased energy demands due to heart failure
Chronic lung disease: e.g., cystic fibrosis
Kidney disorders: renal tubular acidosis, chronic kidney insufficiency
Metabolic disorders: inborn errors of metabolism, hypothyroidism
Infectious diseases: chronic infections such as HIV or tuberculosis
Neurological conditions: swallowing and feeding difficulties associated with neurological disorders

Non-Organic Causes

Insufficient caloric intake: inadequate breastfeeding, incorrect formula preparation, dietary errors
Psychosocial factors: neglect, poverty, parental mental health issues, disrupted parent-child bonding
Feeding disorders: sensory processing difficulties, food refusal

Symptoms

In addition to the primary sign of inadequate weight gain, the following symptoms may be observed:

Slowed linear growth and reduced head circumference gain
Developmental delays (motor, language, and cognitive)
Nutritional deficiencies and signs of malnutrition (pale skin, hair loss, fatigue)
Increased susceptibility to infections
Irritability, apathy, or withdrawal behaviour
Reduced activity and lack of energy

Diagnosis

Failure to thrive is typically diagnosed by a paediatrician during routine well-child visits. Key diagnostic steps include:

Anthropometric measurements: weight, height, and head circumference compared to age-appropriate growth charts
Comprehensive history: dietary history, family history, psychosocial background
Physical examination: assessment for signs of underlying organic disease
Laboratory tests: full blood count, inflammatory markers, thyroid function, kidney and liver values, electrolytes, ferritin, and vitamin levels
Further investigations: depending on clinical suspicion -- ultrasound, stool analysis, echocardiography, or genetic testing

Treatment

Treatment depends on the underlying cause and typically requires a multidisciplinary approach:

Nutritional Therapy

In most cases, optimising caloric intake is the primary focus. This may include a high-calorie diet, specialised infant formula, dietary counselling for parents, or in severe cases, enteral tube feeding (nasogastric tube or PEG tube).

Treatment of Underlying Organic Conditions

If an organic cause is identified, targeted treatment is essential -- for example, a gluten-free diet for coeliac disease, enzyme replacement therapy for cystic fibrosis, or surgical correction for congenital heart defects.

Psychosocial Support

When non-organic causes are involved, social support, parent training, counselling services, and in some cases psychotherapy are key components of treatment. Close collaboration between paediatricians, social workers, psychologists, and dietitians is strongly recommended.

Regular Follow-Up

Frequent weight checks and developmental assessments are essential to monitor treatment progress and make adjustments as needed.

References

Olsen E. M. et al. - Failure to Thrive: The Case for Environmental Etiology. In: Pediatrics, 2007.
Shields B. et al. - Failure to Thrive: A Systematic Review. In: Archives of Disease in Childhood, 2012.
World Health Organization (WHO) - Child Growth Standards and the Identification of Severe Acute Malnutrition in Infants and Children, 2009.

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.

Most read entries

3 Posts in this encyclopedia category