Failure to Thrive

Overview, Causes, & Risk Factors

Failure to thrive in infants and children is usually noticed when they seem to be dramatically smaller or shorter than other children the same age. Teenagers, for example, may have short stature or appear to lack the usual changes that occur at puberty. However, there is a wide variation in normal growth and development. In general, the rate of change in weight and height may be a better indicator of a problem than the actual measurements.

It is important to determine whether the failure to thrive results from medical problems with the child or from psychosocial factors in the environment, such as abuse or neglect.

There are multiple medical causes of failure to thrive that will disturb the body's metabolism enough to result in delayed growth. These include:

• Chromosome abnormalities such as Down syndrome and Turner's syndrome
• Defects in major organ systems
• Abnormalities of the endocrine system, such as 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 that result in delayed growth
• Abnormalities in the cardiac and respiratory systems, which can disrupt deliverly of oxygen and nutrients to the body
• Anemia or other blood disorders
• Abnormalities in the gastrointestinal system, which may result in malabsorption or absence of digestive enzymes, thus resulting in inadequate nutrition
• Some diseases, such as cerebral palsy, chronic gastroenteritis, and gastroesophageal reflux (usually temporary)

Psychological and social causes may include emotional deprivation as a result of parental withdrawal, rejection, or hostility.

Economic factors can affect nutrition, living conditions, and parental attitudes. Environmental factors may include exposure to infections, parasites, or toxins. Sometimes the cause of failure to thrive is simply poor eating habits, such as eating in front of the television and not having formal meal times. Many times the cause cannot be determined.

Risk factors for failure to thrive are related to the causes and may include underlying undiagnosed diseases, poverty, negative emotional environments, and crowded or unsanitary living conditions.