Failure to thrive

Failure to thrive

ICD-10	R62.8
ICD-9	783.41, 783.7
MedlinePlus	000991
eMedicine	ped/738
MeSH	D005183

Failure to thrive (FTT) is a medical term which is used in both pediatric and adult human medicine, as well as veterinary medicine (where it is also referred to as ill thrift).

When not more precisely defined, the term refers to pediatric patients. In MeSH, the term is assumed to refer to an infant or child. In children, it is usually defined in terms of weight, and can be evaluated either by a low weight for the child's age, or by a low rate of increase in the weight.

Infantile/pediatric failure to thrive

As used by pediatricians, it covers poor physical growth of any cause and does not imply abnormal intellectual, social, or emotional development, although of course it can subsequently be a cause of such pathologies. The term has been used in different ways, and different objective standards have been defined. Many definitions use the 5th percentile as a cutoff.

Traditionally, causes of FTT have been divided into endogenous and exogenous causes. Initial investigation should consider physical causes, calorie intake and psychosocial assessment.

• endogenous (or "organic"): Causes can include inborn error of metabolism. Underlying physical causes may not be immediately obvious such as the mother's mastitis, urinary tract infections (UTIs), undiagnosed Cystic Fibrosis (CF) or asthma.

• exogenous (or "nonorganic"): Causes can include having a mother with postpartum depression. Both neglect and hypervigilance can cause failure to thrive. The program outlined in the parenting book On Becoming Babywise is associated with infantile failure to thrive and has been criticized by pediatricians and child abuse advocates.

• Mixed: However, to think of the terms as dichotomous can be misleading, since both endogenous and exogenous factors may co-exist. A child with a disease or disability may be more vulnerable to poor care by a caregiver with marginal competence or resources. These infants typically look cachectic, are prone to infections with difficulty recovering, are often developmentally delayed, have unusual postures, and look sad, withdrawn, apathetic OR hypervigilant, irritable, or angry.^{[citation needed]}

Recently the term 'faltering growth' has become a popular replacement for 'failure to thrive', which in the minds of some represents a more euphemistic term.^{[citation needed]}

Adult/geriatric failure to thrive

The term "failure to thrive" is also applied to geriatrics, or more generally in adult medicine.

In adult medicine, failure to thrive is a descriptive, non-specific term that encompasses "not doing well": e.g. malaise, weight loss, poor self-care that can be seen in elderly individuals.

See also

• Hospitalism