Failure to Thrive

Pediatric Failure to Thrive

Children are said to fail to thrive when presenting with clear underweight or failing to gain weight without an obvious reason. Different medical, psychological, environmental, and social factors are known that can impair normal growth in children.

Medical disorders, notably but not exclusively affecting the digestory tract, may affect food intake, retention, digestion, or absorption. Parental abuse may impair a child's appetite and different environmental and social factors may prevent the child from getting adequate nutrition. These include fam-ily's environment and financial status—the regularity and quality of a child's feeding directly reflect his or her development.

The diagnosis is made when a child's weight or rate of growing is far from what it should be by comparison with previous measures or height-weight charts and the treatment is based on eliminating the underlying cause. Nutritional supplementation is always offered and severe cases are treated in the hospital.

Because the first year of age is crucial in brain development, failure to thrive during this time may result in a permanent mental deficit from mild to severe. The best way to avoid this is based on the early identification and treatment of failure to thrive.

Geriatric Failure to Thrive

Geriatric failure to thrive is a syndrome and a diagnosis of exclusion in older people. It is defined by weight and function loss and it can lead to death in a short time. This condition has a prevalence of 10 to 20 percent after 65 years of age and may be caused by either organic disease or nonorganic problems, such as psychological, functional, or social problems.

Failure to thrive is characterized by progressive loss of physical functioning, weight, and lean body mass. Malnutrition, characterized by a loss of fat mass and visceral protein, is an important risk factor and so is low muscle mass, because it relates to physical function. Failure to thrive as a medical diagnosis is acceptable when its causes cannot be made clear. Almost all chronic systemic diseases and some medications can cause failure to thrive in very old people. Nonorganic [Page 653]causes of failure to thrive are usually linked to inability to get food, lack of interest in food or anorexia, or inability to consume available food. Depression is the most common psychological risk factor. Eating is a social event and it is not a surprise that social isolation also may lead to decreased food intake and failure to thrive. Poverty is also an important risk factor.

Abuse also may cause failure to thrive in the elderly, especially on those more frail and incapable of self-defense. The clinical picture of geriatric failure to thrive due to abuse is nearly identical to the effects of abuse-related pediatric failure to thrive.

The treatment of the potential causes is the basis of treatment of geriatric failure to thrive and dietary supplementation is also important and cost-effective in all cases. Geriatric failure to thrive is often treatable, with a positive impact on an older person's health.

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