Failure to thrive

Failure to thrive (FTT) describes a delay in a child's growth or development.It is usually applied to infants and children up to two years of age who donot gain or maintain weight as they should. Shortly after birth most infantslose some weight. After that expected loss, babies should gain weight at a steady and predictable rate. When a baby does not gain weigh as expected, or continues to lose weight, it is not thriving. Failure to thrive is not a specific disease, but rather a group of symptoms which may come from many sources.Organic failure to thrive (OFTT) implies that the organs involved with digestion and absorption of food are malformed or incomplete so the baby cannot digest its food. Non-organic failure to thrive (NOFTT), the most common type, implies the baby is not receiving enough food due to economic factors, parentalneglect, or psychosocial problems. Occasionally, there may be a physical condition that limits the baby's ability to take in, digest, or process food. These defects can occur in the esophagus, stomach, small or large intestine, rectum or anus. Usually the defect is an incomplete development of the organ, and it must be surgically corrected. Most physical defects can be detected shortly after birth. Failure to thrive may also result from lack of available food or the quality of the food offered. This can be due to economic factors inthe family, parental beliefs and concepts of nutrition, or neglect. If the baby is being breast fed, the quality or quantity of the mother's milk may bethe source of the problem. Psychosocial problems, often stemming from a lackof nurturing parent-child relations, can lead to a failure to thrive. The child may exhibit poor appetite due to depression from insufficient attention from parents.

Most babies are weighed at birth and that weight is used as a baseline for future well-baby check-ups. If the baby is not gaining weight at a predictablerate, the doctor will do a more extensive examination. If there are no apparent physical deformities in the digestive tract, the doctor will examine the child's environment. As part of that examination, the doctor will look at thefamily history of height and weight. In addition, the parents will be asked about feedings, illnesses, and family routines. If the mother is breastfeeding the doctor will also evaluate her diet, general health, and well being as it affects the quantity and quality of her milk. Diagnosis of FTT is confirmed by a positive growth and behavioral response to increased nutrition. If there's a physical reason for failure to thrive, correcting that problem should reverse the condition. If the condition is caused by environmental factors, the physician will suggest ways to provide adequate food for the child. Maternal education and parental counseling may also be recommended. In extremecases, hospitalization or a more nurturing home may be necessary. The firstyear of life is important as a foundation for future growth and physical andintellectual development. Children with extreme failure to thrive in the first year may never catch up to their peers even if their physical growth improves. In about one third of these extreme cases, mental development remains below normal and roughly half will continue to have psychosocial and eating problems throughout life. When failure to thrive is identified and corrected early, most children catch up to their peers and remain healthy and well developed. Initial failure to thrive caused by physical defects cannot be prevented but can often be corrected before it becomes dangerous to the child. Maternaleducation and emotional and economic support systems all help to prevent failure to thrive in those cases where there is no physical deformity.

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