Failure to Thrive

Question 1

Failure to Thrive Definition

Answer 1

Decelerated or arrested physical growth due to inadequate nutrition: height and weight measurements below 3rd or 5th %tile. Downward change in growth across two major growth percentiles.
Can be associated with abnormal growth and development.
Can be either organic or non-organic

Question 2

FTT S/S

Answer 2

lack of appropriate weight gain
irritability
fatigue, sleepiness
lack of age appropriate social response
delayed motor development.
learning/behavioral difficulties later in childhood.

Question 3

Causes of failure to thrive

Answer 3

• Inadequate intake: organic feeding disorders/non-organic feeding disorders.
• Inadequate digestion/absorption
• Inadequate metabolism: chronic inflammation or genetic/metabolic disorders

Question 4

Organic feeding disorders

Answer 4

CP, muscular dystrophy, myasthenia gravis, short frenulum, cleft lip/palate, esophageal ring/fistula/narrowing, congenital heart disease, BPD, hereditary fructose intolerance, urea cycle disorders,

Question 5

Nonorganic feeding disorders

Answer 5

incorrect feeding behavior, selective intake, fear of feeding, psychosocial deprivation

Question 6

Inadequate metabolism

Answer 6

Genetic-metabolic disorders: Williams, Turner, T21, Russell-Silver, Hypothyroidism, GH deficiency, Renal Tubular Acidosis, SCID.
Congenital cardiopathies
Chronic inflammation: IBD, RA

Question 7

Constitutional Growth Delay/ Familial Short Stature

Answer 7

decline in length and weight percentiles. The two curves are parallel. The decline rate of length is driving the decline in weight (not due to nutritional deficiencies). ask family history.

Question 8

Celiac disease growth curve

Answer 8

weight curve decreases first, then drives slight decline in height curve