Defective use of available calories, such as seen with inborn errors of metabolism, can also present with FTT.Anything that increases the metabolic demands will increase caloric requirements (ex, hyperthyroidism, chronic respiratory disease, congenital heart disease).Malabsorption due to inflammatory bowel disease, celiac disease, or cystic fibrosis can play a role.Often has psychosocial component, but while we may want to blame the formula and “protein sensitivity”, be aware….Obviously, vomiting for GI mechanical abnormalities is not going to allow appropriate caloric intake.Difficulty ingestion can also be related to congenital conditions (ex, dyspnea related to congenital heart disease, TE-fistula).Poor appetite may be related to organic disease too (ex, anemia).Often has psychosocial component, but it is not just simply poor feeding….Calories Count and discerning whether the patient has one or a combination of the following will be helpful in determining a useful evaluation strategy.Additionally, while the primary cause may be an “organic” one, it can become exacerbated by “non-organic” causes.“Organic” – typical require medical interventions.“Non-organic” – typically warrant behavioral interventions.This is, conceptually, helpful, but not accurate as there is much overlap between the two.Typically, the conditions that lead to FTT are divided into “Organic” vs “Non-organic” causes.Can certainly also involve child neglect or abuse.Often involves some combination of organic disease and behavioral dysfunction.Poverty is the greatest single risk factor for FTT worldwide.Failure to Thrive is often Multifactorial!.Like ALTE (or BRUE), the question still remains of “Why?” are we having FTT.Normal variations in growth do occur and may appear to met these criteria.
Were “overweight” and height gain increased while weight gain decreased.Definitions may vary between groups, but FTT in a child can be described as:.Growth is compared to growth percentile curves ( see CDC.gov).FTT is associated with cognitive, behavioral, and constitutional consequences.As condition persists, FTT can also include length and head circumference deficits.Failure to Thrive (FTT) describes growth failure primarily based on weight or rate of weight gain.Let’s briefly review some of the issues we should consider ( yes, even in the Emergency Department) when we are dealing with a child who has has Failure to Thrive: Occasionally, that single job of growth becomes too difficult to achieve. We have discussed some Growth and Development topics previously (ex, Milestones, Infant Formula, Growth Estimates). The one job young children have is growing. Children have very few responsibilities and even fewer jobs ( just ask my kids).
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