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Failure to Thrive

Medically reviewed by Last updated on Jul 4, 2022.

What is failure to thrive?

Failure to thrive (FTT) is when your child does not gain weight or grow as fast as he should. FTT is a long-term condition and your child may continue to need treatment and monitoring as he grows up.

What causes FTT?

  • Increased metabolism: Your child may use calories at a faster rate than other children. Certain conditions, such as hyperthyroidism, can increase metabolism.
  • Incorrect feeding: Your child may not be getting enough to eat, or may be eating the wrong kinds of foods. He may be drinking formula accidently made with too much or too little water. He may be having problems with breastfeeding. He may be drinking liquids that are high in sugar, such as fruit juices. Your child may also have a poor appetite or may be a picky eater.
  • Swallowing problems: This may be caused by cleft palate or damage to your child's brain.
  • Problems with nutrient use: Your child's body may not be able to break down, absorb, or store nutrients from the food he eats. Conditions such as celiac disease can prevent the absorption of nutrients.
  • Family stress: Your child may be sensitive to stress at home, such as job loss or the death of a family member. Your child may be around family members who abuse drugs or alcohol, or are abusive. Your child may need more physical or emotional attention.

What are the signs and symptoms of FTT?

  • Height, weight, or head size that is less than that of other children his age
  • Decreased or no appetite at all, or he is a picky eater
  • Diarrhea or vomiting
  • Dry, brittle, or thin hair
  • Low body temperature
  • Looks weak, thin, and fussy, and does not want to be around people
  • Trouble doing things that he should be able to do at certain ages, such as sitting, rolling over, or crawling
  • Trouble with sucking and swallowing during bottle or breastfeeding, or with swallowing food or liquids

How is FTT diagnosed?

Your child's healthcare provider will try to find conditions that may be causing your child's FTT. He will ask about any problems that occurred while your child was still in his mother's womb. He will ask what and how much he is being fed. He may also ask about how your family cares for your child.

  • Growth chart: This is used to compare your child's weight, length or height, and head size to other children his age. Your child's healthcare provider can see if your child is below where he should be for one or more of these measurements.
  • Food diary: You may be asked to keep a written record of what and how much your child eats over several days. This helps your child's healthcare provider see if your child is being fed the proper kinds and amount of food.
  • Blood and urine tests: Your child may need these tests to find the cause of his symptoms.

How is FTT treated?

  • Nutrition management: Your child may need different formula or one with added vitamins to help him grow. Your child may need to eat high-calorie foods, such as cheese, peanut butter, or whole milk. If your child cannot eat or drink, he may need a feeding tube. A feeding tube goes through your child's mouth or nose until it reaches his stomach. Your child will then get formula through the tube until he is able to eat on his own again.
    NG Tube Feeding (Infant)
  • Hospital admission: A hospital stay is needed when treatment outside the hospital has failed or when your child's FTT is severe. This may help healthcare providers find the cause of your child's failure to thrive.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

What are the risks of FTT?

Children with FTT have an increased risk for getting infections. Even with treatment, your child may not have normal increases in weight, height, and head growth. He may develop permanent health conditions. His mental abilities may develop at a slower rate. He may be more at risk for having problems with his behavior. If untreated, FTT can progress to life-threatening malnutrition or dehydration.

What can I do to prevent or manage FTT?

  • Go to follow-up appointments: Take your child to see healthcare providers as recommended. Depending on the cause of your child's problems, you may also need to take your child to other healthcare providers. Lactation counselors, dietitians, social workers, gastroenterologists, or counselors may help you find ways to support your child.
  • Keep records: Measure and record your child's weight as directed. You may also be asked to keep a written record of what and how much your child eats. Bring these records to your child's follow-up visits. This will help you and your child's healthcare providers find if certain foods are causing his problems.
  • Help your child eat well: Do not force your child to eat or feed him too quickly. Praise him when he eats well. Start with small amounts of food and increase the amount over time. Limit snacks so his appetite for a regular meal is not reduced. Limit your child's daily intake of fruit juice to less than 8 ounces. Have meals at regular times with other family members. Do not allow your child to eat while doing other things such as watching TV or playing on the computer. If your child is eating table food, feed him healthy foods such as fruits, vegetables, whole grains, lean meat, and dairy products.
  • Track your child's development: If your child is an infant or toddler, keep track of when he develops new skills or meets certain milestones. These include things like rolling over, standing, walking, talking, and putting words together. A record of these things will make it easier to see if your child is developing normally for his age.
  • Reduce your child's exposure to stress: Find ways to manage stress at home. Ask family members or your child's caregivers if you feel that you need help.

When should I contact my child's healthcare provider?

  • Your child is vomiting or has diarrhea.
  • Your child has a fever, or his skin is red or swollen.
  • Your child is not growing or gaining more weight as fast as he should, even with treatment.
  • Your child is not speaking, walking, or doing other things other children his age can do.
  • You have questions or concerns about your child's condition or care.

When should I seek immediate care or call 911?

  • Your child is very irritable and cannot be consoled.
  • Your child has had fewer than 4 wet diapers in the last 24 hours.
  • Your child's soft spot on the top of his head is sunken.
  • Your child cries without tears, has sunken eyes, and his mouth is dry.
  • Your child is weak and sleeping more than usual.
  • Your child is listless and not responsive to you.
  • Your child's body is swollen, and his skin has an abnormal color. His skin may be peeling.
  • You suspect that someone may be harming or abusing your child.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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