Failure to Thrive

Failure to Thrive

Research Paper

On Infant Bonding Disorders

The first few years of life are a time when most children gain weight and grow much more rapidly than they will later on. Sometimes, however, babies and children don't meet the expected standards of growth. Although most of these children are merely following a variation of the normal patterns and are not at risk, some children are actually considered to have "failure to thrive".

This diagnosis is a general consequence of many possible causes. Every case, however, has one thing in common. That is the failure to gain weight as expected, which is usually accompanied by poor height growth as well. The process of diagnosing and treating a child who fails to thrive is focusing on identifying an underlying problem. Failure to thrive has been recognized for more than a century, but it does not have a specific definition, partly because it describes a condition, not a specific disease. The condition involves children who do not receive, are unable to take in, keep in, or use the calories they need to gain weight and grow as they need to. This affects not only their biosocial development in an obvious way, but has detrimental consequences to a child's cognitive and psychosocial development as well. A child who has had failure to thrive may suffer from mockery, jokes and ridicule for their smaller size, they may be much slower intelligently than their peers, and can have a very difficult time making friends.

Most failure to thrive cases are made in infancy or the toddler years, a crucial period of physical and mental development. After birth, a child's brain grows as much in the first year as it will throughout the rest of the child's life. Poor nutrition during this critical period can have permanent negative effects, not only on a child's physical growth, but also on their cognitive development.

An average term baby doubles his or her birth weight by four months, and then triples it by one year of age. However, children with failure to thrive don't usually meet those steps. A baby does not have to be born small and stay small to have failure to thrive. Sometimes, a baby can be born with plenty of baby fat and show signs of growing well, but then begin to stop gaining weight.

If this condition progresses, that child is at risk of becoming uninterested in his or her surroundings, apt to avoid eye contact, become irritable, and not reaching the developmental milestones, like sitting up, walking and talking, at the usual age.

Failure to thrive can result from many causes. Some children may suffer from social factors. There may be no medical condition at all, but the parents actually cause the failure to thrive. For example, some parents restrict the amount of nutrition they provide for their babies. They may be trying to keep the child from getting fat, or try to keep their baby on a diet similar to their own. Or the child may suffer from worse, a lack of interest from the parents in the child's well being. This neglect is not only harmful to the child's physical well being, but can be detrimental to the baby's cognitive and psychosocial development.

Other causes are many different physical disorders in the child's intestinal system, such as gastroesophageal reflux, chronic diarrhea, cystic fibrosis, chronic liver disease, and celiac disease. These conditions can cause the child pain when they eat, and they refuse because it hurts. Problems involving diarrhea also can cause difficulties with the body's ability to hold the necessary nutrients in. Babies also face things such as malabsorptive disorders, which is when the baby may eat a lot but doesn't absorb or keep enough of the food. If the child has a chronic illness or medical disorder, he or she may not be able to take in enough calories to support normal growth. Metabolic disorders, intolerance of milk protein, and infections can also cause failure to thrive.

Doctors used to categorize cases of failure to thrive as either organic - or caused by an underlying medical disorder, or inorganic - caused by parents' actions. Sometimes however, both the medical and behavioral causes can appear together. If a baby has a hard or painful time eating, the parent may be more likely to become frustrated, and may not try enough times or enough food to feed the child.

If a child fails to gain weight for three months, a doctor becomes concerned and may diagnose failure to thrive. Some of the factors included in the child's development standards are not just height and weight, but also head circumference. After many tests to see if there are any underlying medical problems, a doctor will ask the parents to document very carefully everything the child eats in a day to figure out a caloric intake count. After interviewing and interacting with the parents, a doctor will most likely see if there are any other problems as well, such as neglect, household stress, feeding difficulties, or poverty.

When a child is diagnosed with failure to thrive, it requires many people to work together for the child's condition to be treated and fixed, such as the doctor, a nutritionist, the parents, caregivers, and possibly social workers, psychologists, or mental health professionals if the situation needs it. Usually parents can monitor the baby's intake closely, and with frequent trips to the doctor's office, can cure the problem.

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