Tuesday, October 16, 2012

FAILURE TO THRIVE

Failure to thrive is a term use to describe babies and young children under two years of age who are lighter than
97% of children their age, and who do not put on weight or develop at the expected rate. 
Obviously the most common cause is neglect and starvation, and sometimes this can be difficult for doctors to
detect, and it is only when the child is hospitalised, or information is given by friends or relatives, that this problem
becomes apparent.

Persistent  infection, particularly of  the urine,  is another common cause.  Infections may be  low grade and not
apparent, and urine infections may have no symptoms in young children, and collection of urine samples is difficult,
making them hard to detect.
Infestations of the gut with various worms and parasites must be excluded by examination of a sample of faeces
in a laboratory.
Genetic factors must also be considered. If both parents are very small, then the child may be also be small, but
completely healthy.
A wide range of uncommon diseases can cause failure to thrive. If one of the common causes above cannot be
found,  it may be necessary  to undertake extensive  investigations  to  find a  long  term disease  that  is affecting  the
child’s growth. Examples  include diabetes  (rare under  two years), pyloric stenosis  (narrowing of  the outlet of  the
stomach), Down syndrome (mongolism), Turner syndrome (girls born with only one X chromosome instead of two),
Fanconi syndrome  (failure of  the kidneys), major heart valve and artery abnormalities  (eg. Fallot  tetralogy, patent
ductus arteriosus), cystic fibrosis (failure of the glands throughout the body), coeliac disease (intolerance to gluten
in  flour),  failure of any of  the body’s major hormone producing glands  (eg.  thyroid gland, pituitary gland, adrenal
glands and parathyroid glands) and a diet deficient in iron or other essential nutrients.
Numerous other rare congenital and acquired conditions may also cause failure to thrive.

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