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Common Growth Concerns

10 Common Causes of Failure to Thrive

Failure to thrive (FTT) is a condition affecting 5 to 10% of children, according to American Family Physician (AFP). It’s not a disease or illness, but instead a cluster of symptoms and measurements that, when interpreted together, indicate problem. Children are diagnosed with FTT when they fall below the 5th percentile for weight based on their age and gender.

AFP suggests that the most common reason for FTT is inadequate calorie intake, which is considered nonorganic FTT, also sometimes called psycho-social FTT. A non-organic diagnosis occurs when there are no known medical reasons for the condition; when FTT is being caused by problems in the child’s environment or home life.

Organic FTT, according to Children’s National Healthy System, occurs when there is an underlying medical problem that’s causing the symptoms. In many cases, children experience FTT from a mix of both organic and nonorganic causes.

As such, each cause needs to be evaluated and addressed to help the child recover and begin to grow normally. Here’s what you need to know about FTT. If your concerned about your child’s weight, see your pediatrician first and foremost.

More: Growing Kids: Simple Things Parents Can Do to Help Them Along

Causes of Organic Failure to Thrive

Digestive Problems

Several different medical conditions affecting the digestive tract can lead to FTT, including chronic diarrhea, celiac disease, Crohn’s disease, or gastroesophageal reflux (GERD). All of these conditions can lead to malabsorption, due to frequent diarrhea or vomiting, which prevents the body from properly absorbing calories, according to GI Kids.

This can lead to problems with gaining weight, as well, even if your child is eating enough calories. In the case of GERD, eating can also be painful due to acid coming up from the stomach. If your child then refuses to eat, her or she may not be getting enough calories.

Food Allergies or Intolerances

When a child has a food allergy, exposure to that food may cause an anaphylactic reaction that, if severe enough, can be life-threatening. Children with food allergies may need to avoid calorie-dense foods such as dairy, nuts or other important sources of protein, limiting their food choices and leading to poor weight gain and FTT.

On the other hand, a food intolerance is not immediately life-threatening and can vary in severity. A common symptom of food intolerance is diarrhea, abdominal pain, or other digestive problems after eating a specific food. According to Enzyme Science, intolerances are caused by a lack enzymes needed to digest certain foods, which cause gas, bloating, and diarrhea. These digestive symptoms caused by food intolerances can prevent proper absorption of calories or prevent a child from eating a wide variety of nutritious foods, leading to problems with growth and possibly FTT.

Chromosomal Abnormalities

Genetic conditions such as Down Syndrome or Turner’s Syndrome can cause FTT, according to John’s Hopkins, which can lead to improper utilization of calories.

Chronic Infections

An infection with parasites, recurring urinary tract infections, or chronic infections can cause a decrease in appetite and reduce absorption of nutrients. Once these illnesses are treated, usually the FTT improves.

Birth or pregnancy complications

Pregnancy and birth complications, such as pre-term birth or low-birth weight, can cause FTT. According to Emory University of Medicine, premature birth can lead to FTT in a number of ways. Children born prematurely may have already experienced prenatal undernutrition. Gastrointestinal problems are also common for children born prematurely, suggests Emory, including reflux and GERD. These children may also experience oral aversion, which can reduce their calorie intake.

Metabolic Disorders

Metabolic disorders are illnesses that affect the metabolism or chemical processes of the body and can lead to FTT, according to CHOC Children’s Hospital. These can be discovered at birth or later in life. They can cause extreme fatigue, weight loss, and problems with eating.

More: Why Vitamin A is Important for Children’s Growth

Causes of Non-organic Failure to Thrive

Non-organic FTT affects 80 percent of children who are diagnosed with the disorder, according to pediatricians at duPont Hospital for Children. There are many non-organic causes of FTT; keep reading to learn about those which are most common.

Not Enough Calories

In many cases of failure to thrive, the child is not receiving enough calories due to improper feeding or problems with feeding. When a baby is breastfed, FTT can be the result of three potential issues, according to The College of Family Physicians of Canada: “maternal milk production, milk transfer at the breasts, and the quantity and quality of milk intake by the baby.”

In Nutritional Approach to Failure to Thrive, report authors explain that if a baby is formula fed, FTT can be caused by improper preparation of the formula or not enough consumed to meet caloric needs. or not providing enough to support growth. Failure to thrive can also occur when a child is transitioning to solids from breastmilk or formula.

Economic Issues

FTT is often associated with lower socioeconomic status, and 11.8 percent of American families were food insecure in 2017. In this case, a child may not get enough calories because there may be a problem with food availability. Without the financial resources to purchase enough foods, children intake fewer calories.

Picky Eating

At times, children simply don’t eat enough to support their growth, even if they are provided with enough food. It is normal for kids to go through phases of picky eating, but if the habit is consistent, it’s wise to work with your pediatrician or a pediatric dietician to learn strategies for increasing calorie intake.

More: How to Get Picky Eaters to Eat

Mental Health of Mother Primary Care Giver

Maternal mental significantly impacts the child’s ability to grow and thrive. Children’s National Health System explains:

“The mother or primary caregiver may neglect proper feeding of the infant because of preoccupation with the demands or care of others, her own emotional problems, substance abuse, lack of knowledge about proper feeding, or lack of understanding of the infant's needs.”

The Many Causes of Failure to Thrive

As you can tell, if a child is diagnosed with failure to thrive, there are often more than one underlying causes. All causes must be discovered and addressed to help the child recover and begin to grow properly. Since it is a multi-factorial condition, a diagnosis of FTT may take time as the child’s doctor gathers all of the information necessary and monitors the child’s growth. Once the diagnosis is made and the causes are determined, treatment can begin.

Treatment may involve regular visits to speech therapy, occupational therapy, a Registered Dietitian, or a psychologist. Medical doctors who are specialists in various areas may also need to be involved, especially if there is an underlying medical cause.

When you work closely with the necessary professionals, you can begin to address challenges and allow your child to begin growing at the expected rate. Speak with your child’s pediatrician if you’re concerned about their growth.

The content in the Healthy Height Growth and Nutrition Guide is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

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