Thứ Hai, 13 tháng 1, 2014

Failure to Thrive in Infants

Failure to Thrive in Infants Some children will not gain normal weight during development and those children are referred to failure to thrive. Their developmental rate and weight gain will be significantly lower than that of healthy children.

Failure to thrive in infants is marked by inadequate weight gain and retarded development in infants below 2 years of age. Children belonging to this group will not gain normal weight range and will not attain expected growth rate as they grow. It is quite common for many children to be on low weight due to causes like below average birth-weight, social factors and psychological factors.

It is not a medical disorder and FTT is only indicative of under-weight children.

Causes :

Several factors contribute to FTT in infants. It is a common phenomenon in children with Down’s syndrome and Turner’s syndrome. Children born with inherited organ problems can have difficulty in gaining weight. This can occur due to insufficient production of thyroid hormone or growth hormone in children.

Some children with severe nervous disorders may have feeding problems which can contribute for inadequate weight. FTT can be caused due to blood related disorders, gastrointestinal diseases like esophageal reflux.

Insufficient intake of calorie can be the cause for poor weight-gain due to poverty, parental neglect, poor diet and improper diet. It can be due to misbehavior of the child during feeding sessions or due to food phobia.

Anatomic factors that are responsible for poor weight-gain are congenital (inherited by birth) problems, esophageal trauma, cleft palate, GI infection, GE reflux and abdominal pain.

Some children may not utilize the calorie intake due to mal-absorption caused by liver disease, cystic fibrosis, celiac disease, inflammatory bowel disease, and diarrhea.

This can happen due to premature born infants, babies with chronic infections like HIV or due to pulmonary disorders and renal problems.

This can be caused due to metabolic disorders which can lead to poor eating habits.

Some of the social factors that cause failure to thrive in infants are poverty, illegitimate children and problems in family after child-birth. It can happen due to parental rejection or due to exposure to infections.

Children below the poverty line may not get nutritious food like healthy children and this can cause inadequate growth.

Symptoms :

Children who fall under this category will be shorter and smaller than regular children of same age. For them puberty will be delayed and even if happens it may not cause necessary changes in secondary sexual characters.

The weight and height of failure to thrive children will be much lower than expected rate. They will not have expected weight that matches with their height. For some children the growth will stop once it reaches average line.

However these children will have delayed developmental stage and physical skills like crawling, sitting and standing will be delayed. It may affect their social skills as well as their mental ability since they have low self esteem.

Some infants may have this problem due to poor feeding method. Other symptoms of such children are excess of crying, lethargy attitude and constipation problem. They will easily get irritated for small things due to weakness.

Diagnoses :

Your doctor will easily identify the failure to thrive children by looking at their height and weight and examining their body shape. He may order for blood profile, hormone test for measuring thyroid level, electrolyte balance test, urine test and X-ray. He may also conduct Denver development screening test for measuring any developmental delay.

Treatment :

Underlying causative factor should be determined before starting the treatment. The child should be given nutritious diet. In case the baby is found to be deficient of certain vitamins the doctor would give supplementary vitamins in the form of oral pills.

For infants having thyroid problems, suitable therapy and medications are prescribed.

Often those children are treated as outpatients. But if the child has any organic problem he should be hospitalized. The child should be closely observed during feeding time and total liquid intake will be increased gradually. Sometimes experienced nurse will take over feeding the child until he reaches normal weight. For some children it can be due to lack of child-parent relationship or due to hostile behavior towards the child.

Inpatient care of the child will rule out problems like dehydration, anemia, and infection, since the child will be put on intravenous fluids. For some children nasogastric feeding is done through tube for setting right the weight issue.

Surgery is to be done for children born with birth-defects in gastrointestinal tract or congenital heart problem.

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