Description:
Failure to thrive (nonorganic, NOFTT; also called psychosocial failure to thrive) is defined as decelerated or arrested physical growth (height and weight measurements fall below the fifth percentile, or a downward change in growth across two major growth percentiles) associated with poor developmental and emotional functioning. Organic failure to thrive occurs when there is an underlying medical cause. Nonorganic (psychosocial) failure to thrive occurs in a child who is usually younger than 2 years old and has no known medical condition that causes poor growth.
Etiology:
It is important to determine whether failure to thrive results from medical problems or factors in the environment, such as abuse or neglect.
There are many medical causes of failure to thrive. These include: * Chromosome problems such as Down syndrome and Turner syndrome * Organ problems * Thyroid hormone deficiency, growth hormone deficiency, or other hormone deficiencies * Damage to the brain or central nervous system, which may cause feeding difficulties in an infant * Heart or lung problems, which can affect how nutrients move through the body * Anemia or other blood disorders * Gastrointestinal problems that make it hard to absorb nutrients or cause the body to have a lack of digestive enzymes * Long-term gastroenteritis and gastro esophageal reflux (usually temporary) * Cerebral palsy * Long-term (chronic) infections * Metabolic disorders * Complications of pregnancy and low birth weight
Other factors that may lead to failure to thrive: * Emotional deprivation as a result of parental withdrawal, rejection, or hostility * Poverty * Problems with child-caregiver relationship * Parents do not understand the appropriate diet needs for their the child * Exposure to infections, parasites, or toxins * Poor eating habits, such as eating in front of the television and not having formal meal times
Many times the cause cannot be determined.
Manifestation:
Children that fail to thrive seem to be much smaller or shorter than other children the same age. Teenagers may not appear to have the usual changes that occur at puberty. However, it's important to remember that the way children grow and develop varies quite a bit. See: Normal growth and development
Symptoms of failure to thrive include: * Height, weight, and head circumference do not match standard growth charts. * Weight is lower than 3rd percentile (as outlined in standard growth charts) or 20% below the ideal weight for their height. * Growth may have slowed or stopped after a previously established growth curve.
In general, the child's rate of change in weight and height may be more important than the actual growth measurements.
Children who fail to thrive may have the following delayed or slow to develop: * Physical skills such as rolling over, sitting, standing and walking * Mental and social skills * Secondary sexual characteristics (delayed in adolescents)
Babies who fail to gain weight or develop often have a lack of interest in feeding or a problem receiving the proper amount of nutrition. This is called "poor feeding."
Other symptoms that may be seen in a child that fails to thrive include: * Constipation * Excessive crying * Excessive sleepiness (lethargy) * Irritability
Impact on nutritional status of child: Failure to thrive and loss of weight can cause serious complications in young children. Without prompt treatment, malnutrition in infants and toddlers can cause permanent physical and mental stunting, minimizing the possibility of your child reaching his full potential. A diet deficient in energy, protein, vitamins and minerals can lead to malnutrition in children. This deficiency may occur due to a lack of available food sources, an inability to absorb nutrients or poor feeding. Infants that lack interest in feeding may have an underlying medical condition that interferes with appetite. Metabolic disorders, structural problems and neurological disorders can result in poor feeding habits in infants and young children.

http://emedicine.medscape.com/article/985007-overview http://www.rch.org.au/clinicalguide/cpg.cfm?doc_id=13848 http://www.umm.edu/ency/article/000991.htm