Failure to thrive causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S[2]

Overview

Causes of failure to thrive are mainly organic and non-organic. Organic causes are further divided into inadequate calorie intake, inadequate calories absorption and increased calorie expenditure.

Causes

• The most common cause of failure to thrive is inadequate calorie intake.
• Causes can broadly be divided into organic and non-organic causes.

1. Non organic causes include:
   1. Social, psychological, and environmental factors
   2. Non accidental trauma – subdural hematoma
   3. Low socioeconomic status
   4. Child neglect, abuse, and poor parent-child interaction
   5. Poverty
   6. Poorly educated parents
2. Organic causes can further be subdivided into;
   1. Inadequate caloric intake
   2. Excessive calorie expenditure "Failure To Thrive - StatPearls - NCBI Bookshelf".
   3. Inadequate calorie absorption "Failure to Thrive: A Practical Guide - American Family Physician".

Inadequate calorie intake	Excessive calorie expenditure	Inadequate calorie absorption
Poverty and inadequate food storage Feeding difficulties- poor infant feeding technique, improperly reconstituted formula, uninhibited access to high calorie food, behavioral problems related to feeding Inadequate breast milk production, breastfeeding failure, errors in artificial feeding, poor latch/suck strength Mechanical or structural problems with swallowing; cleft lip, cleft palate, neuromuscular disease, motor neuron disease Prenatal insult – worsening of prematurity or intrauterine growth restriction Erratic diets – unorthodox beliefs, Munchausen syndrome by proxy Systemic diseases causing decreased appetite, anorexia, and food refusal.	Chromosomal conditions – trisomy 13,trisomy 18, trisomy 21, Turner’s syndrome Congenital heart disease – cyanotic and non-cyanotic heart diseases. Teratogenic exposures – anti-epileptics, tetracyclines Endocrine dysfunction – growth hormone deficiency, type 1 Diabetes mellitus Cirrhosis of liver Chronic respiratory illness, intrauterine infections Malignancy Thyroid dysfunction Renal tubular acidosis, Renal failure Increased Intracranial pressure Immunodficiency syndrome causing recurrent infections, e.g. HIV	Bowel obstruction - Ladd bands, paralytic ileus, small intestinal bowel obstruction Necrotizing enterocolitis /Short bowel syndrome Pyloric stenosis Gastro-esophagal reflux disease Cystic fibrosis Pancreatic insufficiency Malabsorption Pancreatic insufficiency, Celiac disease Giardiasis Inflammatory bowel disease Inborn errors of metabolism – amino acid disorders, lysosomal storage diseases Enzyme deficiencies Biliary atresia Cow’s milk protein allergy

References

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