Failure to thrive

Question 1

What is the differential diagnosis of FTT?

Answer 1

• Inadequate nutritional intake : not enough food offered, child not taking in enough, excessive juice, formula dilution
• Malabsorption/loss : gastrointestinal (GI) mucosal disease, pancreatic dysfunction, cholestatic liver disease, persistent vomiting
• Increased metabolic demand : congenital heart disease, chronic lung disease, chronic renal failure, acidosis, congenital or chronic infections, chronic systemic disease, genetic syndromes.

Question 2

What features of history suggest a medical condition leading to FTT?

Answer 2

Recurrent vomiting, chronic diarrhea, frequent infections, and failure to gain weight despite adequate caloric intake

Question 3

What features on physical examination suggest a medical condition leading to FTT?

Answer 3

Dysmorphic features, cardiac exam abnormalities, organomegaly or lymphadenopathy