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Health Issues

Failure to Thrive

At each of your child’s checkups, your pediatrician’s office should plot your child’s weight and measurements. In general, you should see a continuous upward trend, although there will be times when she gains very slowly and perhaps some weeks when she actually loses a little weight due to illness. It is not normal for her to stop growing or to lose weight except for the small amount she loses during the first few days of life. If she does lose weight, it is a clear sign either that she is not getting enough to eat or that she is ill. The medical term for this condition is failure to thrive. Although it can happen in older children who are seriously ill or undernourished, it is most common and most dangerous during the active growth period of the first three years.

If allowed to continue for a prolonged period, this condition can become serious. Steady weight gain is especially important for infants and toddlers because it means that they are receiving adequate nutrition and care for normal physical, mental, and emotional development.

Usually when a child stops growing, it is due to a feeding problem that prevents her from getting as many calories as she needs. As a newborn, she may be too fussy to eat as much as she needs, or, if breastfed, she may not be getting enough milk while nursing. Some children may require more food than their parents are able to provide. These problems must be detected and treated early in order to avoid long-term or permanent damage.

Sometimes failure to thrive signals a medical problem. The newborn may have an infection passed on from her mother during pregnancy, or she may have a hormonal difficulty, an allergy, or a digestive problem that prevents nutrients from being absorbed into the body properly. Diseases such as cystic fibrosis, diabetes, or heart disease also can interfere with normal growth. If one of these is present, the child may need a special diet as well as medical treatment.

When to Get Help

Regularly charting your child’s growth, and comparing her general development with others her age, are the best ways to make sure she is thriving. If she does not gain weight, grow in length, or otherwise develop normally, consult your pediatrician. He will measure and examine your child, ask about her diet and eating patterns, and review her medical history for signs of illness that may be contributing to her failure to thrive. The physician will try to establish exactly when the growth or weight gain stopped, and ask about anything that may have contributed to this. The pediatrician also may watch your child eating or nursing to see how much she consumes and how she responds to food. Sometimes a short period of in-hospital observation may be necessary.

If the doctor discovers a physical cause for the decrease in growth rate, he will recommend the appropriate treatment. If there is no physical reason, however, the pediatrician will look for emotional or social problems, particularly within the family. Such disturbances can decrease a child’s appetite or alter her normal food intake and digestion. Once discovered, these difficulties can be treated with individual or family counseling.

Last Updated
Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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