APPROACH OF FAILURE TO THRIVE

  • Mónica Tavares Pediatric Department of CH Porto
  • Inês Vaz Matos Pediatric Department of CH Porto
  • Anabela Bandeira Pediatric Department of CH Porto
  • Margarida Guedes Pediatric Department of CH Porto; Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto
Keywords: Failure to thrive, nutritional assessment, diagnosis, treatment

Abstract

Introduction: Failure to thrive is one of the most frequent consultation referrals in Pediatrics. Both the dificulties in its definition and the different approaches lead to a lack of consensual management. The fact that, in about 70% of the cases, the causes of failure to thrive are non organic, complicates this issue.

Objective: With this review the authors aim to propose a diagnostic and management strategy to evaluate and monitor these patients.

Methods: Review of relevant articles published on the designation of “failure to thrive” or “fallo of medro” using the databases PubMed and Cochrane.

Development: The most frequent cause of failure to thrive is related to an inadequate energy intake conditioned by psychosocial or behavioral problems. In fact only 5% of the causes of poor weight gain can be attributed to organic disease, which makes a systematic approach of these children even more dificult. The random use of laboratory tests contributes very little to the underlying diagnosis and is not recommended. A multidisciplinary approach of these children and their families, ideally with home monitoring, associated with an optimization of food intake is effective in weight gain and in a better interaction between the children and the caregivers.

Conclusions: Early recognition of this situation, associated with a multidisciplinary approach, optimized the energy intake, minimizes the long-term consequences.

References

Jaffe AC. Failure to Thrive: Current Clinical Concepts. Pediatr

Rev 2011; 32:100 -8.

Gahagan S. Failure to Thrive: A Consequence of Undernutrition.

Pediatr Rev 2006; 27:e1 -11.

Zenel JA. Failure To Thrive: A General Pediatrician’s Perspective.

Pediatr Rev 1997; 18:371 -8.

Wright CM, Weaver LT. Image or reality: why do infant size

and growth matter to parents? Arch Dis Child 2007; 92:98-

-100.

Hughes I. Confusing terminology attempts to deÞ ne the unde-

Þ nable. Arch Dis Child 2007; 92:97 -8.

Diéguez SV. Fallo de medro en lactante. BSCP Can Ped

; 29:103 -9.

Bauchner H. Failure to Thrive. In: Nelson Textbook of Pediatrics.

th Ed. Philadelphia, PA: WB Saunders; 2007.p.184 -7.

Merino AB, Romero CC. Protocolos diagnóstico -terapéuticos

de Gastrenterologia Hepatologia y Nutrición Pediátrica

SEGHNP -AEP. Actuación ante un niño con fallo de medro.

Disponível em: http://www.gastroinf.es/sites/default/Þ les/Þ les/

Protocolos%20SEGHNP.pdf

Conde AP, González BS. Fallo de medro. Bol Pediatr 2006;

:189 -99.

Bousoño -García C, Ramos E. Fallo de medro. An Pediatr

Contin 2005; 3:277 -84.

Ficicioglu C, Haack K. Failure to thrive: When to suspect inborn

errors of metabolism. Pediatrics 2009; 124:972 -9.

Mei Z, Grummer -Strawn L. Comparison of changes in Growth

Percentiles of US Children on CDC 2000 Growth Charts With

Corresponding Changes on Who 2006 Growth Charts. Clin

Pediatr (Phila) 2011; 50:402 -7.

Wright CM. IdentiÞ cation and management of failure to thrive:

a community perspective. Arch Dis Child 2000; 82:5 -9.

Wright CM, Parkinson KN, Drewett RF. The inß uence of maternal

socioeconomic and emotional factors on infant weight

gain and weight faltering (failure to thrive): data from prospective

birth cohort. Arch Dis Child 2006; 91:312 -7.

Connor K, Lennon R, McGraw ME, Coward RJM. A fair reason

for failing to thrive. Arch Dis Child Educ Pract Ed 2008;

:50 -7.

Chang SJ, Chae KY. Obstructive sleep apnea syndrome in

children: Epidemiology, pathophysiology, diagnosis and sequelae.

Korean J Pediatr 2010; 53:863 -71.

Krugman SD, Dubowitz H. Failure to Thrive. American Family

Physician 2003; 68:879 -84.

Emond A, Drewett R, Blair P, Emmett P. Postnatal factors

associated with failure to thrive in term infants in the Avon

Longitudinal Study of Parents and Children. Arch Dis Child

; 92:115 -9.

Olsen E, Skovgaard A, Weile B, Petersen J, Jorgensen T.

Risk factors for weight faltering in infancy according to age at

onset. Paediatr Perinat Epidemiol 2010; 24:370 -82.

Frisancho AR. New norms of upper limb fat and muscle

areas assessment of nutritional status. Am J Clin Nutr

:34:2540 -5.

Olsen EM, Petersen J, Skovgaard AM, Weile B, Jørgensen,

Wright CM. Failure to thrive: the prevalence and concurrence

of anthropometric criteria in a general infant population. Arch

Dis Child 2007; 92:109 -14.

Raynor P. Anthropometric indices of failure to thrive. Arch Dis

Child 2000; 82; 364 -5.

Sills RH. Failure to thrive: the role of clinical and laboratory

evaluation. Am J Dis Child 1978; 132:967 -9.

Spencer NJ. Failure to think about failure to thrive. Arch Dis

Child 2007; 92:95 -6.

Wright CM, Callum J, Birks E, Jarvis S. Effect of community

based management in failure to thrive: randomized controlled

trial. BMJ 1998; 317(7158):571 -4.

Corbett SS, Drewett RF. To what extent is failure to thrive

in infancy associated with poorer cognitive development? A

review and meta -analysis. J Child Psychol Psychiatry 2004;

:641 -54.

Black MM, Dubowitz H, Krishnakumar A, Starr RH Jr. Early intervention

and recovery among children with failure to thrive:

follow -up at age 8. Pediatrics 2007; 120:59 -69.

Rudolf MC, Logan S. What is the long term outcome for children

who fail to thrive? A systematic review. Arch Dis Child

; 90:925 -31.

Published
2017-01-16
How to Cite
Tavares, M., Matos, I. V., Bandeira, A., & Guedes, M. (2017). APPROACH OF FAILURE TO THRIVE. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 22(3), 162-166. https://doi.org/10.25753/BirthGrowthMJ.v22.i3.10647
Section
Review Articles