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By Jeannette; Matheny, Samuel C.; Lewis, Evelyn L. South-Paul

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Extra resources for Current Diagnosis & Treatment In Family Medicine

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Complications Developmental delay may persist in children with FTT well past the period of undernutrition. Studies have repeatedly shown that these children, as a group, have more behavioral and cognitive problems in school than their peers, even into adolescence. One caveat about these studies is that many defined failure to thrive by that classic definition: growth failure associated with disordered behavior and development. These studies do not doom every child with FTT to scholastic and social failure: but the clinician must be vigilant and act as the child's advocate.

This old definition is useful because it reminds the practitioner of the serious sequelae associated with undernutrition. Currently, FTT is more commonly defined by anthropometric guidelines alone. Weight less than the third percentile for age is a classic definition. However, this definition includes children with genetic short stature and children whose weight transiently dips beneath the third percentile with an intercurrent illness. Weight crosses two major percentiles downward over any period of time.

These children typically have reduced weight for height as do children with FTT. However, unlike children with FTT they ultimately gain both weight and height on a steady curve. Family history is often revealing in constitutional growth delay. Querying parents about the onset of their own pubertal signs may seem intrusive, but often gives the clinician the information needed to reassure parents about their child's growth. Breast-feeding infants may be growing normally and not follow the CDC growth curves.

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Current Diagnosis & Treatment In Family Medicine by Jeannette; Matheny, Samuel C.; Lewis, Evelyn L. South-Paul


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