failure to thrive

Failure to thrive is the general diagnosis applied when, for whatever reason, a young child does not grow as expected. The growth failure must be significant and more than transient. In this regard, growth failure is identified when weight gain drops off relative to height gain, violating the principle that a child should parallel growth percentiles on the standard growth chart

Failure to thrive can have organic causes, as well as non-organic or neuropsychological causes. Organic causes include just about every serious disease of childhood, including cancer, inflammatory bowel disease, juvenile arthritis, or cystic fibrosis. Often the appearance of failure to thrive is the first indication that a child has a serious illness, often months to years in advance of overt evidence of the underlying disease. This of course leads to a diligent search for the root cause of the failure to thrive.

Non-organic causes of failure to thrive involve failure of the normal cycle of maternal-child emotional interaction, or bonding if you will. Because lack of emotional stimulation and feedback can literally turn off the infant production of growth hormone, these cases are often the most severe. Severe non-organic failure to thrive is potentially fatal. Infant malnutrition develops as the baby becomes progressively unable to digest and absorb nutrition and the baby dies of starvation or overwhelming sepsis. Non-organic failure to thrive is associated with severe maternal depression or other serious mental illness, maternal substance abuse, or severe sociopathic personality disorder.

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