FAILURE TO THRIVE (FTT)
Failure to Thrive (FTT) is defined as 'growth deceleration' in a young child. The term usually implies one the following patterns:
- weight gain is below the 3rd or 5th percentile
- or weight gain has crossed two of the major percentile markers on a growth chart.
Failure to thrive is a symptom of an underlying process; and the goal of evaluation is to determine that underlying cause. Failing to grow reflects one of four problems:
- Inadequate intake
- Malabsorption
- Excess caloric demand
- Inability to properly utilize nutrients (often, but not always, metabolic disease)
Failure to thrive has traditionally been divided into two broad categories: organic and non-organic. While useful for discussion, there are often elements of both inadequate calories and environmental stresses when infants and children are not gaining enough weight.
Organic FTT
- Inadequate caloric intake
- malabsorption
- increased caloric requirement
- Metabolic disease which interferes with proper utilization or storage of nutrients
Non-organic FTT
Non-organic Failure to Thrive is the failure of a child under age 5 years to gain weight due to environmental challenges. The term is reserved for cases for which an organic cause cannot be identified and implies that there are psychological or environmental etiologic factors present. Non-organic failure-to-thrive is diagnosed based upon the demonstrated ability of a child to gain weight properly when given adequate nutrition. However, it is not unusual for a child with non-organic FTT to have associated medical or developmental issues which present challenges to a otherwise emotionally or financially stressed caretaker.
