Failure to Thrive

Question 1

What is failure to thrive?

Answer 1

Poor physical growth and development in a child

Question 2

What are the definitions of failure to thrive in terms of fall in weight?

Answer 2

One or more centile space if below 9th centile
Two or more centile spaces if between 9th and 91st centile
Three or more centile spaces if above the 91st centile

Question 3

What categories of causes of failure to thrive are there?

Answer 3

Inadequate nutritional intake
Difficulty feeding
Malabsorption
Increased energy requirements
Inability to process nutrition

Question 4

What nutritional intake problems can cause failure to thrive?

Answer 4

Maternal malabsorption (breastfeeding infants)
Iron deficiency anaemia
Neglect
Availability of food

Question 5

What feeding difficulties can cause failure to thrive?

Answer 5

Pyloric stenosis
Abnormal face structure
Cleft lip/palate
Poor suck (ie due to cerebral palsy)

Question 6

What malabsorption problems can cause failure to thrive?

Answer 6

Cystic fibrosis
Coeliac disease
Cows milk intolerance
Chronic diarrhoea
IBD

Question 7

What increased energy requirement problems can cause failure to thrive?

Answer 7

Hyperthryoidism
Congenital heart disease
CF
Chronic infections

Question 8

What inabilities to process nutrition can cause failure to thrive?

Answer 8

Type 1 diabetes
Inborn errors of metabolism

Question 9

What parameters suggest further investigation of failure to thrive?

Answer 9

Height more than 2 centile spaces below the mid-parental height centile
BMI below the 2nd centile

Question 10

What intial investigations should be performed in all children with failure to thrive?

Answer 10

Urine dipstick
Coeliac screen