Definition
Failure to thrive is a medical condition characterized by a child's weight or weight gain being significantly below the expected range for their age and gender. Infants or young individuals who have failed to thrive exhibit noticeable stunted growth or diminished stature compared to youngsters of the same age. Meanwhile, adolescents who do not achieve growth may exhibit reduced stature or lack typical pubertal development. Nevertheless, there is considerable divergence in defining the parameters of regular growth and development.
Causes
Various factors can contribute to an individual's failure to thrive, including genetic predisposition, hormone imbalances, systemic illnesses, and impaired nutrient absorption. It is crucial to ascertain whether failure to flourish is attributable to a medical illness or environmental problems, including abuse or neglect.
Although it is typically challenging to pinpoint the precise cause of failure to thrive, the following are some examples of potential contributors:
- A family history of short stature
- Abnormal phases of puberty, including late and early puberty
- Obstetric complications, including fetal growth disorders
Additionally, the following health conditions may contribute to an individual's inability to flourish:
- Abnormalities of the chromosomes, including Down syndrome and Turner syndrome
- Endocrine disorders, including but not limited to diabetes, insufficiency of thyroid hormone, growth hormone, or other hormone deficiencies
- Brain or central nervous system damage that can result in feeding difficulties in infants
- Heart or lung conditions that impact the circulation or allocation of nutrients and oxygen throughout the body
- Anemia or additional hematological disorders
- Gastrointestinal disorders are characterized by insufficiency of digestive enzymes or impaired absorption.
- Prolonged inflammation of the gastrointestinal tract and gastroesophageal reflux
- Chronic (long-lasting) infection
- Physiologic disorder
- Bone pathologies
Most of the over fifty bone diseases that impact growth and height are inherited. Achondroplasia, a form of dwarfism characterized by an infant having arms and legs shorter in length than their body, is the most prevalent disease. Additional body proportions that are impacted consist of a skull comparatively larger than an average-sized torso.
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Risk Factors
Several variables that can increase the risk of failure to thrive include:
- Psychological issues stemming from parental detachment, rejection, or conflict
- The economic challenges impact nutrition, living conditions, and parenting attitudes.
- Exposure to pathogens, parasites, and poisons
- Unhealthy dietary practices, such as consuming meals while watching television and lacking consistent meal schedules,
Symptoms
Overall, the incremental growth rate in weight and height continues to be more significant than instantaneous measurements of these parameters.
The growth curve does not correspond to the height, weight, and head circumference of children or infants who do not thrive. Growth will decelerate or cease, notwithstanding the presence of typical growth in the past.
Children who experience failure to thrive will have developmental impairments in the following areas:
- Motor skills, such as the ability to rotate one's body, assume a seated position, rise to a standing position, and ambulate
- Cognitive and interpersonal skills
- Secondary sexual features, which typically emerge throughout late adolescence
- Learning disorders
- Prone to fatigue or debility
- Prone to anger
Diagnosis
Your pediatrician should diagnose failure to thrive, and the specific procedure employed will vary based on your child's symptoms. Following a physical examination, the doctor will request a thorough medical history, including height and familial medical history. Furthermore, the physician may perform examinations that include:
- Monitor your child's health and development over a specific period.
- Hematological examinations (to evaluate the existence of endocrine, chromosomal abnormalities, or other illnesses associated with inadequate growth)
- Pituitary gland imaging to identify any anomalies in the production and regulation of growth hormone.
- An X-ray of the child's hand or wrist is performed to assess bone development about the child's height and chronological age and to determine their growth potential.
Early diagnosis of development problems is crucial to enable prompt treatment.
Management
The course of treatment depends upon the underlying etiology of the growth and development delay. Treating the underlying medical problem can effectively treat the growth disorder.
Hormone replacement therapy is frequently incorporated into this condition's management regimen. Hormone injections may be administered daily or weekly as part of the treatment regimen. The positive news is that substantial growth improvements are frequently observed with this treatment. During the initial year of treatment, children with growth hormone deficiency will, on average, grow 10 cm taller; however, children with other growth disorders will experience a lesser increase in height.
Malnutrition-induced growth retardation can be remedied through parental education on the importance of providing a well-rounded diet. The doctor can provide dietary recommendations and suggest suitable food options and substitutes based on the required nutritional content.
If psychological factors contribute to the development of the problem, therapy should encompass enhancing family relations and living situations. It is important to analyze parental attitudes and conduct, as they can impact children's issues. Under specific circumstances, a kid may necessitate hospitalization to carry out an all-encompassing therapeutic regimen that encompasses medical, behavioral, and psychosocial interventions.
Once your child's growth has reached the standard level, they may still require assistance maintaining physical and mental growth within the usual range. Children may need physiotherapy, speech therapy, occupational therapy, and nutritional advice assistance.
Complications
A child who fails to thrive is susceptible to experiencing complications such as:
- Short stature
- Psychological and affective issues
- Delays in the process of growth and maturation
- Cognitive impairments
- Challenges in the process of learning knowledge
Prevention
Regular assessment of a child's growth and development can mitigate growth failure or at least aid in prompt identification and treatment. This condition can originate during pregnancy and persist throughout adulthood. The physician will document your child's growth on a chart based on age and gender.
A child who fails to thrive may have stunted growth compared to youngsters of the same gender and age. The growth pattern may exhibit instability. Regular consultations with a pediatrician are crucial for precisely assessing your child's development.
When to see a doctor?
You should consult a doctor if your child is experiencing difficulty feeding, appears to be losing weight, or is not gaining weight as anticipated. Consultation with a medical professional promptly can alleviate concerns and ensure your child receives appropriate nutritional and health support before developing difficulties.
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- dr. Lukita Tarigan