Failure To Thrive
Definition
Any of the following:
Causes
Any of the following:
- < 3rd percentile
- Drop of weight across 2 major percentile lines
Causes
Inadequate Caloric Intake/Retention
Clinical features
S ubcutaneous fat loss
M uscle wasting
A lopecia
L agging behind normal
L ethargy
K awashiorkor (protein deficiency - oedema, ulcers, irritability)
I nfections
D ermatitis
DDx
Investigations
Source
Toronto Notes 2012
www.rch.org.au 2014
- Inadequate amount of food provided
- Poor breast feeding technique
- Structural causes of poor feeding eg cleft palate
- Persistent vomiting
- Anorexia of chronic disease
- Coeliac disease
- Chronic Liver disease
- Pancreatic insufficiency eg Cystic Fibrosis
- Chronic diarrhoea
- Urinary Tract Infection
- Chronic Respiratory disease eg Cystic Fibrosis
- Congenital Heart disease
- Diabetes Mellitus
- Hyperthyroidism
- Genetic syndromes
- Inborn Errors of Metabolism
- Parental depression
- Coersive feeding
- Distractions at meal times.
- Poverty
- Behavioural disorders
- Poor social support
- Neglect
Clinical features
S ubcutaneous fat loss
M uscle wasting
A lopecia
L agging behind normal
L ethargy
K awashiorkor (protein deficiency - oedema, ulcers, irritability)
I nfections
D ermatitis
DDx
- Prem
- Catch down growth (GDM --> macrosomic - normal)
Investigations
- Bedside: Stool for fat globules and fatty acid crystals (CF, coeliac), Urine MCS
- Bloods: FBE/CRP (infections), U&E (dehyration), LFT, TFT, Ferritin (anaemia, inflammation)
Source
Toronto Notes 2012
www.rch.org.au 2014