Failure to Thrive (Faltering Growth)

Failure to thrive, now often called faltering growth, is weight or weight-for-length below the 5th percentile for age and sex, or weight that falls across two or more major percentile lines on the growth chart. Weight falls first while length and head circumference stay normal for a time, so low weight with normal length suggests too few calories. Organic failure to thrive comes from an underlying disease such as congenital heart disease, cystic fibrosis, reflux or malabsorption. Nonorganic failure to thrive is inadequate intake from poverty, feeding errors, a disturbed caregiver–child relationship or neglect, and most cases are mixed. The nurse weighs the infant on the same scale, unclothed, at the same time of day, keeps strict intake and output with a calorie count, and observes a feeding for technique and interaction. Steady weight gain once the infant is fed well in the hospital points to an intake cause. Care includes a consistent primary nurse, calm feedings, high-calorie formula as ordered, and teaching never to dilute formula. Suspected neglect is reported to child protective services.