From the Guidelines
No, "failure to thrive" (FTT) is still a commonly used term in medical terminology, and it has not been entirely replaced by "faltering growth". The term "failure to thrive" is often used to describe a child who is not gaining weight or height at a healthy rate, and it is usually defined as a child whose weight or height falls below the 5th or 10th percentile for their age and sex 1. Faltering growth, on the other hand, is a more general term that refers to a situation where a child's weight or height gain is significantly slower than expected for their age and sex. When assessing growth issues in children, healthcare providers will:
- Plot the child's growth on standardized growth charts
- Evaluate the child's diet and feeding patterns
- Consider any underlying medical conditions
- Assess family dynamics and socioeconomic factors Management typically involves addressing any underlying causes, optimizing nutrition, and providing support to families. Regular follow-ups are crucial to monitor progress and adjust interventions as needed, as seen in cases of chronic kidney disease where optimal nutritional management might result in catch-up growth in infants even with severe CKD 1. In some cases, failure to thrive can be a symptom of an underlying condition, such as cardio-facio-cutaneous syndrome, which is often accompanied by severe feeding problems and poor growth in infancy 1. It's also important to note that growth retardation without a known cause is referred to as failure to thrive, which is one of the leading developmental disorders among young children and a common cause of pediatric hospitalization 1. Therefore, healthcare providers should continue to use the term "failure to thrive" to describe children who are not gaining weight or height at a healthy rate, and to prioritize addressing any underlying causes and optimizing nutrition to improve growth outcomes.
From the Research
Definition and Terminology
- The term "failure to thrive" (FTT) has been used for over 50 years to describe an infant or young child whose growth falls substantially behind that of their peers 2.
- However, the term FTT has been largely replaced by "pediatric growth faltering" or "faltering growth" in recent studies 3, 4.
- Growth faltering is a broad term that describes children who do not reach their expected weight, length, or body mass index for age 4.
Causes and Evaluation
- Inadequate caloric intake is the most common cause of growth faltering, and can be identified with a detailed feeding history and physical examination 3, 4.
- Other causes of growth faltering include malabsorption, existing congenital or chronic medical conditions, and child neglect or abuse 5.
- Evaluation of growth faltering requires repeated growth measurements over time using local, age-appropriate growth centile charts, as well as a thorough history and physical examination 5, 6.
Management and Prognosis
- Management of growth faltering typically involves caregiver education about childhood nutrition, frequent monitoring of growth parameters, and a multidisciplinary approach that includes nutritionist, developmental therapist, and other specialty team member involvement 3, 4, 6.
- Children with growth faltering are at risk of future growth and development problems, but those without significant medical comorbidities who are treated with enhanced nutrition have a good prognosis for returning to a healthy baseline 6.