Non-organic Failure to Thrive: An Overview

What Is Failure to Thrive?

Failure of the child to attain sufficient weight and height as per the age and sex is called failure to thrive. The child’s weight and height are measured and compared to the standard growth charts as suggested by the pediatrician. When the child's growth does match the age on the growth charts, it is said as a failure to thrive. This can be otherwise called a weight less than the fifth percentile on the standard growth chart.

What Are the Types of Failure to Thrive in Children?

Failure to thrive is divided into three categories:

• Organic failure to thrive.

• Non-organic failure to thrive.

• Combination of both organic and non-organic failure to thrive.

What Is Organic Failure to Thrive?

Failure of the child to meet the growth and height as per the standards suggested by a pediatrician. Children with organic failure to thrive exhibit underlying medical problems, leading to improper nutrient absorption from the food and decreased metabolism. Because of this, the child does not meet the required milestones as per age.

Symptoms of organic failure to thrive include:

• Frequent vomiting.

• Diarrhea after having food.

• Impaired metabolism may be due to fructose intolerance or inborn errors of metabolism.

When these underlying disorders are corrected, children usually return to their normal weight and height.

What Is Non-organic Failure to Thrive?

Non-organic failure to thrive is not a disease. It is simply a disorder that can be reversed, where the child does not receive proper nutrition and, thereby, does not meet the standard requirements of growth and height. Growth failure just not only affects the height and weight of the child but also affects the social, physiological, and emotional well-being of the child. The prime reason for non-organic failure to thrive is the improper communication or connection between mother and child or caretaker and child.

What Are the Causes of Non-organic Failure to Thrive?

The main reasons for non-organic failure to thrive include:

1. Poverty: Results in insufficiency or lack of food.

2. Having a Child at a Very Young Age: Married women who deliver the child at a very young age lack the knowledge of how to feed the child, and improper feeding practices lead to malnutrition in the children.

3. Lack of Knowledge: Lack of knowledge in the mother would result in improper mixing of formula fed to the child. As a result, the formula could be over-diluted. As a result, children will not receive sufficient nutrients for their growth.

4. Prolonged Hospitalization of the Child: Due to prolonged hospitalization, children could develop depression disorder because of the gap created between the child and the mother. In these conditions, the child becomes reluctant to take the food.

5. Lack of Stimulus: Lack of stimulus to the child also results in improper food uptake. The stimulus can be in the form of pampering, spending quality time with the child, performing routine duties towards the child (feeding, bathing), and building up communication with the child. The lack of stimulus by the mother is mainly because of the:

• Disturbance in marital life.

• Improper parenting skills.

• Reluctant towards the child.

• Priority work other than children.

• Too many children in the family, where the focus of the mother gets distributed.

Usually, the role of caretaker is secondary to the mother. Proper feeding and caring start from the mother rather than the caretaker.

What Are the Symptoms of Non-organic Failure to Thrive (NOFTT)?

Symptoms include:

• Usually, children with NOFTT prevent eye contact.

• Irritation and fatigue are common.

• Absence of age-appropriate behavior.

• Improper weight gain.

• Stunted growth.

• Does not feel like communicating with others.

• Lack of cognitive development.

• Children with NOFTT do not want to get socialized.

• They are usually cranky and throw temper tantrums.

• Do not show any response to vocal sounds.

How to Diagnose NOFTT?

NOFTT is diagnosed on routine check-ups, which pediatricians do, and the diagnostic tools include:

1. Standard Growth Charts: During the routine wellness check-ups doctor generally measures the height and weight of the child and compares them to growth charts.

2. Physical Examination: During physical examination, the doctor checks for signs of abnormalities.

3. Medical History: This includes the child's birth history, feeding history, and any health issues faced by the child.

4. Laboratory Diagnosis: If the child is found to be lagging in growth, then the lab tests are advised, which include:

• CBP (complete blood picture).

• ESR (erythrocyte sedimentation rate).

• Urine tests, including urine culture.

• Stool analysis.

How to Treat NOFTT?

Treatment starts with proper nursing of the child.

• Children should be fed whole food, which includes carbohydrates, proteins, fats, vitamins, and minerals.

• If needed, multivitamin supplements should be given as suggested by the doctor.

• Recovery depends on how well the child has been taken care of.

What Precautions Should Be Taken by the Mother to Prevent NOFTT?

When the child is showing symptoms of NOFTT, immediate attention should be given to the child, which includes:

• The mother or caretaker should design a timetable under the supervision of the doctors. The timetable should include diet, rest, sleep, and activities (both outdoor and indoor). The diet plan should consist of three meals and two snacks per day.

• Implementation of the timetable is done in the first twenty-four hours. Then after that, if necessary, any changes should be made according to the suggestion of the doctor.

• Mothers should be very kind to their children, and unnecessary nagging and shouting should be avoided.

• Bonding between mother and child is very important. This helps in communication between the child and the mother.

• Parents should spend maximum time with their children by involving in activities like playing, hugging, feeding, singing rhymes, and diaper changing.

Conclusion:

Non-organic failure to thrive is mainly caused by the parents' and caretakers' social and emotional negligence, where the child does not exhibit sufficient growth as per age. The prognosis depends on the nutritional intake and psychological support given to the child by the mother. In the end, every parent should feel the responsibility of their child.