Threshing disorders in babies usually no longer occur in health-threatening dimensions today due to regular preventive medical checkups. However, if there are indications that a child is not thriving properly, medical help is essential.
What is failure to thrive?
Failure to thrive is when an infant or young child does not appear to be developing appropriately for his or her age. In newborns, this is determined by the weight trend. In the first months of life, they should gain an average of 200 grams per week. If this average value is significantly undercut on a permanent basis, a failure to thrive may be present. Failure to thrive in infancy is determined not only by weight and height, but also by motor and speech development. For example, if motor development is extremely slow when weight and height are also below average, a failure to thrive may be present.
Causes
Causes of failure to thrive in infants are usually due to insufficient food intake. Breastfeeding is still clearly the best food for infants and is also naturally high in calories. If breastfeeding goes well, a baby gets all the energy it needs from this. However, breastfeeding problems, even those that are not noticed by the mother at first, can also be the cause of failure to thrive. Other causes can be insufficient energy and nutrient intake through the porridge. Between the 5th and 7th month of life, complementary feeding is usually started. If breastfeeding is then discontinued or milk bottles are reduced, although the child is still not eating enough porridge, the weight curve can drop significantly. This can be associated with slower development during this phase. Even later in infancy, failure to thrive is usually due to affected children not eating enough or eating primarily empty calories.
Symptoms, complaints, and signs
Failure to thrive refers to a child’s overall physical development. Overall, affected children are too light for their age and size. They are either lighter than 97 percent of children in their age group or their weight development is slower than that of other children over the long term. In cases of prolonged failure to thrive, length growth is also impaired. It is often assumed that a failure to thrive already exists if the children remain very thin. However, this is not the case if the growth in length is normal and the children continue to perform well. Even in these cases, the body is sufficiently supplied with energy and nutrients. However, in cases of failure to thrive, not only weight and growth are delayed, but often cognitive, mental and motor development are also delayed. The body of these children suffers not only from a lack of energy but also from a lack of important proteins, minerals, trace elements and vitamins. Failure to thrive leads to fatigue and listlessness in addition to growth retardation. In addition, the children also suffer from the symptoms of the underlying diseases. These can be digestive disorders caused by food intolerances such as celiac disease, malabsorption in gastrointestinal diseases or food allergies. On the other hand, failure to thrive also occurs in mental illnesses associated with eating disorders. These include anorexia, autism, or intellectual disabilities.
Diagnosis and course
The course of failure to thrive can be gradual. Especially with the first child and in the first weeks of life, parents do not have much experience and often no direct comparisons to other babies, how they thrive. Therefore, it is not always immediately noticeable when a child does not thrive properly. For this reason, the diagnosis of failure to thrive is often made for the first time at the pediatrician’s office. During regular check-ups, children are measured and weighed, and their head circumference is also recorded. From these values, the pediatrician can read which percentile curve the baby or toddler is on. Anything below the percentile curve is considered underweight or significantly too small. In this case, further development must be monitored even more closely.
Complications
As a rule, failure to thrive can lead to very serious complaints and complications in the child.In the worst case, the child dies due to the failure to thrive if it is not treated or treatment is delayed. This often leads to malnutrition and thus to an undersupply of important nutrients and vitamins. As a result, the child’s development is restricted and cannot proceed normally. For this reason, there are disturbances of growth and also disturbances of mental development and intelligence. In case of a persistent failure to thrive, retardation also occurs, which usually cannot be corrected in adulthood. In most cases, failure to thrive can be treated relatively well, although the mother must always seek medical advice to prevent subsequent damage. Complications can be prevented by adequate and healthy nutrition, so that no further complaints occur. The life expectancy of the child is not affected if the disorder is recognized and treated in time. In some cases, parents suffer from psychological discomfort due to the failure to thrive.
When should one go to the doctor?
If a child’s failure to thrive is noticed by relatives or people in the immediate environment, a doctor should be consulted. If the child has a developmental disorder, it is necessary to initiate timely check-ups. If the child shows significant delays in development in direct comparison with peers, a doctor should be consulted. If the growth is reduced, the cognitive abilities are clearly reduced or if a learning disability is recognizable, the observations should be clarified by a doctor. If there are concentration problems, if the child’s attention is unusual, if orientation difficulties occur or if memory problems are apparent, a doctor is needed. If the child tends to be socially isolated and turns away from peers, family members or other people in the environment, it is advisable to contact a doctor. Behavioral abnormalities such as an aggressive demeanor, refusal of food, or disturbances in processing information as well as stimuli from the environment are worrisome. If malnutrition develops due to the refusal of food or if an eating disorder develops, a visit to the doctor must be made. Skin abnormalities, regulation problems and metabolic irregularities should be examined and treated by a doctor. If there is listlessness, sleep disturbances, the development of anxiety, apathy or a reduction in the joy of life, it is necessary to see a doctor.
Treatment and therapy
To effectively treat failure to thrive, it is necessary to know its causes. This is where a medical approach must be taken. If, for example, it turns out that breastfeeding problems are the cause of the failure to thrive, this should not, and in no way need to, mean stopping breastfeeding. The pediatrician and midwife can give the mother important tips on how to increase milk production. A set pattern of latching onto the breast can also be helpful to further stimulate milk production and thus provide the baby with more high-calorie food. Regular weighing, which should not degenerate into coercion, ensures the success of the treatment. Occasionally, it may also be necessary to supplement feeding, at least in phases, until the weight curve and overall development are satisfactory again. If an infant suffers from failure to thrive, the first step is to analyze the daily diet. Young children often have phases in which they do not want to eat much, but at the same time have a high urge to move. This can cause the weight curve to crash. High-calorie foods, lots of milk for example, can often quickly correct a failure to thrive. Again, regular checks are important.
Outlook and prognosis
Failures to thrive are serious side effects of an underlying condition. They can mean that the baby will continue to struggle with the sequelae for the next few years of life. However, children at this age already have great strength, so if the underlying condition is treated appropriately and identified early, failure to thrive may just as well have no effect on health in childhood or adulthood. An exact prognosis can be made by the treating pediatrician, because this depends on the underlying disease, the general health of the baby, body weight and time of birth.In the case of failure to thrive, it is important to consider not only what this does to a baby’s physical health, but also to its psychological development. If, for example, it is necessary from a medical point of view to admit the baby as an inpatient or to place a premature baby in an incubator, this may be good for the physical health, but it still means a certain separation of mother and child. This can have a negative impact on the child’s emotional development and consequences for the development of a good mother-child bond. In the treatment of failure to thrive and the triggering underlying diseases, care should therefore be taken to ensure that the baby can still develop as normally as possible during this time, is supported according to its possibilities and that the mother-child bond also does not suffer from the situation.
Prevention
Breastfeeding mothers can best prevent a possible failure to thrive by learning about breastfeeding before the birth. Breastfeeding groups, for example, offer many tips and tricks for beginners. If you know what to look out for at the beginning, things often work out much better and failure to thrive occurs less frequently. The midwife is an important help to every mother. In case of problems, she can accompany the young family even beyond the eighth week of life. Midwives also advise on nutritional issues. If a failure to thrive is suspected, going to the pediatrician is also a good preventive measure. If he or she really detects a failure to thrive, appropriate measures can be taken immediately to counteract it before thriving is seriously jeopardized.
Aftercare
Failure to thrive is a very serious and life-threatening condition that requires urgent medical monitoring. Only after successful treatment should all measures be taken to ensure that failure to thrive does not recur. Other options for aftercare are usually not possible. The affected child must first be provided with food to compensate for the discomfort of the disorder. Food should be taken that contains a relatively large number of calories in order to provide the child with energy. Furthermore, regular examinations by a midwife or by a pediatrician are also necessary in order to detect damage to the child’s body and furthermore also to treat it at an early stage. The doctor must also look at the child’s diet in order to clarify any misunderstandings on the part of the parents. In many cases, contact with other parents is also useful, as this can lead to an exchange of information that is useful for everyday life. The failure to thrive can usually be treated well. Support from one’s own family or friends is also useful in this disease.
This is what you can do yourself
In most cases, failure to thrive can be well prevented. Patients also have a variety of self-help remedies available to limit the symptoms. After birth, the mother should directly address breastfeeding. In this regard, useful information can be acquired directly at the hospital or at breastfeeding groups. In this way, the disorders can be completely avoided in most cases. The midwife can also provide guidance and advise on proper and healthy feeding. The earlier a failure to thrive is detected, the faster and easier it can be treated. In the case of failure to thrive, milk production should be stimulated. Regular and frequent weighing of the child can also counteract this disorder. This is because difficulties often arise when feeding young children and babies. When the urge to move is high, nutrition should be provided in the form of a high-calorie meal. However, parents should always pay attention to a healthy weight and diet. If there are any questions, it is always advisable to contact a doctor directly. Direct medical treatment of failure to thrive is only necessary in a few cases.
