Failure to thrive is a medical phrase used to describe a child with poor growth related to inadequate nutrition or excess calorie expenditure. There are a variety of causes of failure to thrive in children and some are more serious than others.   Failure to thrive is often discovered during routine health maintenance visits with your doctor. Every child should be measured and weighed at each visit with their pediatrician. These values should be plotted on a growth curve to determine trends. A child with a weight less than the third percentile, or who shows a significant deceleration of growth should be evaluated for medical problems. With failure to thrive, the child's weight is typically affected prior to changes in linear growth and head circumference. The treatment for failure to thrive depends on the cause.

What is failure to thrive? 

Put simply, failure to thrive is inadequate growth in a child.  This may be the first sign of a medical illness, malnutrition, or neglect.

How is failure to thrive diagnosed?

Measurements of a child's weight, height, and head circumference are plotted on a graph which compares these values to expected normals.  A child with a weight below the third percentile for her age or a significant decrease in velocity of weight gain would be considered failure to thrive.

What are the causes of failure to thrive?

Inadequate intake of calories 

• Malnutrition 
• Neglect 
• Improper mixing of baby formulas 
• Excess intake of low calorie foods or drink 
• Poor feeding technique
• Inappropriate lack of appetite

Excess loss of calories 

• Diarrhea 
• Vomiting 
• Spitting up  

Inadequate absorption of calories

• Fat malabsorption 
• Pancreatic insufficiency 
• Cholestasis (Inappropriate secretion of bile)
• Celiac disease 
• Food allergy 
• Cystic fibrosis 
• Inflammatory bowel disease (i.e., crohn's disease or ulcerative colitis) 
• Lactose intolerance 
• Liver disease 
• Short gut syndrome (i.e., After surgical removal of part of the intestines) 
• Vitamin or mineral deficiencies 

Overuse of calories

• Chronic diseases 
• Chronic inflammation 
• Heart disease 
• Lung disease  

Other

• Genetic disorders 
• Metabolic disease  

How is the cause of failure to thrive determined?

History and physical

A wide variety of tests are available depending on the suspected category of failure to thrive (i.e., inadequate intake of calories, loss of calories, overuse of calories, etc.).

How is failure to thrive treated? 

• Again, this depends on the cause.  
• Underlying medical conditions should be treated.
• Appropriate calorie intake should be verified. 
• Consult with a nutritionis.

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