Failure to thrive overview: Difference between revisions
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==Historical Perspective== | ==Historical Perspective== | ||
Amidst rapidly rising infant and child death rates, Dr. Henry Dwight was the first to add a clean environment and constant supervision to the management strategy of failure to thrive patients. As time has progressed, red flags and the present strategy of nutritional rehabilitation followed by a vigilant and prolonged follow up period has been developed. | |||
==Classification== | ==Classification== | ||
There is no established classification system for failure to thrive. Based on cause, it may be divided into organic and non-organic failure to thrive. | |||
==Pathophysiology== | ==Pathophysiology== | ||
The most common cause of failure to thrive is inadequate calorie intake. This may be secondary to psychological causes, poor environmental status, poor calorie absorption and underlying medical conditions that cause excessive energy expenditure. | |||
==Causes== | ==Causes== | ||
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. | |||
==Differentiating Failure to thrive from Other Diseases== | ==Differentiating Failure to thrive from Other Diseases== | ||
It is important to differentiate failure to thrive into organic and non-organic causes. Furthermore, using the concepts of bone age, chronological age, catch up growth and catch down growth, conditions such as constitutional growth delay and familial short stature should also be considered. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
The prevalence of failure to thrive depends on the development status of the country. Studies have suggested a prevalence rate of approximately 5% in the United States of America. | |||
==Risk Factors== | ==Risk Factors== | ||
It is important to differentiate risk factors from causes. Major risk factors to be considered include an unsafe, dirty environment, history of parental psychiatric illness, substance abuse, marital conflict, low birth weight, chromosomal disorders and dental caries. | |||
==Screening== | ==Screening== | ||
There are no established screening protocols established for failure to thrive. | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
The most common presenting complaint is poor growth and failure to gain weight. The patient may have more specific complaints depending on the underlying cause. A few important complications include a diminished final weight and height, vitamin deficiencies and an increase risk of recurrence of failure to thrive. Not much data is available on the prognosis of failure to thrive as it is a multifactorial process. However, the duration of malnutrition is directly proportional to the cognitive and physical decline of the patient. | |||
==Diagnosis== | |||
===Diagnostic Study of Choice=== | ===Diagnostic Study of Choice=== | ||
There is no diagnostic study of choice for failure to thrive. Various definition such as weight for age less than the 5th percentile for age, weight for height less than the 5th percentile for age or a drop in more than two percentiles on the growth chart may be used. The initial approach involves a thorough history and physical examination. This will help narrow the diagnosis, identify red flags and then determine the need for hospitalization. | |||
===History and Symptoms=== | ===History and Symptoms=== | ||
The most common presenting complaint is poor growth and failure to gain weight. The patient may have more specific complaints depending on the underlying cause. A few important complications include a diminished final weight and height, vitamin deficiencies and an increase risk of recurrence of failure to thrive. Not much data is available on the prognosis of failure to thrive as it is a multifactorial process. However, the duration of malnutrition is directly proportional to the cognitive and physical decline of the patient. | |||
===Physical Examination=== | ===Physical Examination=== | ||
Revision as of 14:02, 13 September 2020
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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
Historical Perspective
Amidst rapidly rising infant and child death rates, Dr. Henry Dwight was the first to add a clean environment and constant supervision to the management strategy of failure to thrive patients. As time has progressed, red flags and the present strategy of nutritional rehabilitation followed by a vigilant and prolonged follow up period has been developed.
Classification
There is no established classification system for failure to thrive. Based on cause, it may be divided into organic and non-organic failure to thrive.
Pathophysiology
The most common cause of failure to thrive is inadequate calorie intake. This may be secondary to psychological causes, poor environmental status, poor calorie absorption and underlying medical conditions that cause excessive energy expenditure.
Causes
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.
Differentiating Failure to thrive from Other Diseases
It is important to differentiate failure to thrive into organic and non-organic causes. Furthermore, using the concepts of bone age, chronological age, catch up growth and catch down growth, conditions such as constitutional growth delay and familial short stature should also be considered.
Epidemiology and Demographics
The prevalence of failure to thrive depends on the development status of the country. Studies have suggested a prevalence rate of approximately 5% in the United States of America.
Risk Factors
It is important to differentiate risk factors from causes. Major risk factors to be considered include an unsafe, dirty environment, history of parental psychiatric illness, substance abuse, marital conflict, low birth weight, chromosomal disorders and dental caries.
Screening
There are no established screening protocols established for failure to thrive.
Natural History, Complications, and Prognosis
The most common presenting complaint is poor growth and failure to gain weight. The patient may have more specific complaints depending on the underlying cause. A few important complications include a diminished final weight and height, vitamin deficiencies and an increase risk of recurrence of failure to thrive. Not much data is available on the prognosis of failure to thrive as it is a multifactorial process. However, the duration of malnutrition is directly proportional to the cognitive and physical decline of the patient.
Diagnosis
Diagnostic Study of Choice
There is no diagnostic study of choice for failure to thrive. Various definition such as weight for age less than the 5th percentile for age, weight for height less than the 5th percentile for age or a drop in more than two percentiles on the growth chart may be used. The initial approach involves a thorough history and physical examination. This will help narrow the diagnosis, identify red flags and then determine the need for hospitalization.
History and Symptoms
The most common presenting complaint is poor growth and failure to gain weight. The patient may have more specific complaints depending on the underlying cause. A few important complications include a diminished final weight and height, vitamin deficiencies and an increase risk of recurrence of failure to thrive. Not much data is available on the prognosis of failure to thrive as it is a multifactorial process. However, the duration of malnutrition is directly proportional to the cognitive and physical decline of the patient.