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FAILURE TO THRIVE

DESCRIPTION

Failure to thrive means the failure of infants, children, and adolescents to grow and develop normally. This is different from marasmus, in which infants in emotionally deprived environments become listless, weaken, and sometimes die. Failure to thrive affects young children (1 to 5 years) of both sexes.
Appropriate health care includes:
  • Physician's monitoring of general condition and medications.
  • Psychotherapy or counseling, if the parents have emotional problems that prevent a healthy relationship with the child.
  • Hospitalization (short-term), if complicated diagnostic procedures are necessary or the child's food intake must be verified.
  • Home care.

    SIGNS & SYMPTOMS

  • Persistent vomiting in an infant between 0 and 6 months.
  • Height, weight, and head circumference do not progress normally, as measured on doctors' growth charts.
  • Physical skills are slow to develop. Such skills include: -- Turning over in bed. -- Sitting. -- Standing and walking.
  • Mental and social skills are delayed. These skills include: -- Talking. -- Social interaction. -- Self-feeding. -- Toilet training. Normal growth and development vary widely. The rate of change--as measured at regular medical checkups -- is more significant.

    CAUSES

  • Parental inexperience.
  • A negative emotional environment (neglect, abuse, or rejection).
  • Malnutrition.
  • Chronic disease, such as kidney failure or chronic infection.
  • Genetic disorders, such as Down syndrome or cystic fibrosis.
  • Endocrine diseases, including disorders of the thyroid, pituitary, adrenal, pancreas, and sexual glands.

    RISK FACTORS
    Poverty; parents who were raised in a negative emotional environment or are poorly educated; crowded or unsanitary living conditions.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Arrange for parenting classes if you are an expectant mother or father.
  • Take your child regularly to the doctor for "well-baby" checkups.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Tests, such as the Denver Developmental Test, which measures the child's growth and development.
  • Laboratory blood tests, including hormone studies.
  • X-rays of the child's hands, which provide a good measure of body growth.

    POSSIBLE COMPLICATIONS

    Permanent mental, emotional, or physical disability.

    PROBABLE OUTCOME

  • If a child's failure to thrive is caused by parental inexperience or psychological problems, recovery is possible with education and counseling for the parents.
  • If a child's failure to thrive is caused by an underlying physical illness or disorder, including malnutrition, recovery depends on whether the condition can be corrected.

    TREATMENT

    HOME CARE

  • Read books and pamphlets on child-rearing, or attend parenting classes.
  • Ask a visiting nurse to visit your home for guidance.
  • Provide as much love and support as possible for your child. Examine your feelings and behavior toward your child. If you don't think they are what they should be, arrange for psychological counseling.

    MEDICATION
    If an underlying disorder is causing failure to thrive, your doctor may prescribe medication to treat the child's condition.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS

  • Provide your child with an adequate, well-balanced diet. See Appendix 24.
  • If malnutrition is causing your child's failure to thrive, your doctor may prescribe a special diet.

    OK TO GO TO SCHOOL?

    Yes. Make every attempt to keep activities normal for your child's age.

    CALL YOUR DOCTOR IF

    You are concerned that your child is not developing properly. Trust your instincts--obtain a second doctor's opinion, if necessary.

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