Scott: Failure to Thrive Flashcards
How common is failure to thrive?
5-10% of children seen in primary care
FTT is higher in these populations
poorer rural and urban communities
children with special health care needs
T/F: FTT can cause poor long term health consequences and cognitive development
True
What are the nutritional causes of FTT?
inadequate calorie/nutrient intake
inadequate absorption
increased metabolic demand/increased calorie requirement
What is the most common cause of FTT seen in primary care?
inadequate energy intake
ex: breastfeeding problem, improper formula preparation, discoordination of suck/swallow/breathe, cleft lip/palate, constipation, IBS, GERD
What are some examples of causes of inadequate energy uptake?
Malabsorption GI malformation Inborn error of metabolism Food intolerance or allergy Celiac disease Diabetes Renal Disease
What are some examples of causes of high metabolic needs leading to FTT?
Prematurity Chronic infection or immunodeficiency disease Pulmonary disease Congenital heart disease or heart failure Seizure disorder Thyroid disease Chronic pulmonary disease; asthma Heart disease or failure Malignancy
What are some red flags that suggest medical causes of FTT?
cardiac findings developmental delay dysmorphic features recurrent/severe infections recurrent vomiting, diarrhea, or dehydration
Two important components of the work-up for FTT?
CBC - can show anemia or lymphopenia
CMP - can show renal disease, electrolyte disorder, protein malabsorption
What are some things you want to look for in feeding?
breast attachment - look at latch, look at suck/swallow/breath
look for feeding problems - gagging, choking, reflux
food refusal, picky eating
How long should you breast feed?
for the first 6 months & up to 12 months
What are some benefits of breast feeding?
Composition uniquely tailored to changing needs of growing infant
Inexpensive, convenient, “green”, attractive packaging
Fewer allergies, intestinal upsets, ear infections in infancy
Lower rates of diabetes and asthma in later life
Association between breastfeeding and improved school performance
Helps uterus regain pre-pregnancy size more rapidly
Women who breastfeed have lower rates of breast and ovarian cancer and fewer hip fractures in later life
Do infants need water?
no, they don’t need extra water - should be getting enough in their formula
When is good to offer first food? What food should you offer?
When are finely chopped baby foods ok?
4-6 months;
rice cereal (thin & then thicken as baby adapts);
7-10 months
When are most babies ready to eat with utensils?
When to stop bottle and transition to cup?
8-9 months;
begin offering a cup at 6 months, & cut down on bottles at 9-10 months
