Managment of Failure To Thrive

Abdullatiff Sami Al-RashedBlock 3.4

College of Medicine, KFUAl-Ahsa, Saudi Arabia

How do you treat a case of failure to thrive with special

reference to nutritional management?

How do you treat a case of failure to thrive with special

reference to nutritional management?

Introduction

• The term FTT is used to describe instances of growth failure or, more specifically, failure to gain weight appropriately.

• A wide variety of medical problems and psychosocial stressors can contribute to FTT

Management • The primary goal of management of

failure to thrive (FTT) is improved nutritional status through provision of adequate nutrient intake for catch-up growth.

• Provision of adequate nutrient intake may require changes to the diet, feeding schedule, or feeding environment; psychosocial stressors contributing to undernutrition also must be addressed.

Management • Management of children with FTT is

individualized according to the needs of the child and family that were identified during the evaluation and the severity of the FTT.

• Successful management of FTT requires a plan to address contributing medical, nutritional, developmental/behavioral, and psychosocial factors.

Management

Management • Nutritional therapy is the mainstay of

management. • The goal of nutritional therapy is to enable

"catch-up" weight gain (ie, weight gain at a rate that is two to three times greater than average for age or approximately 45 to 60 g/day) so that the weight deficit is repaired or overcome.

• The pace and aggressiveness of nutritional repletion is determined by the degree of malnutrition.

Nutritional Requirements • Energy and protein — All children with

failure to thrive (FTT) require a diet high in energy and other nutrients for catch-up growth.

• Vitamins and minerals — During the catch-up growth phase, existing stores of vitamins and minerals may not be sufficient. A multivitamin preparation that includes iron and zinc for children who are being treated for FTT is recommended

• Increasing intake — Strategies to achieve adequate intake of energy and protein vary depending upon the age and dietary preferences of the child.

Nutritional Requirements  

Infant Formula Preparation 

OTHER INTERVENTIONS• Medical — Medical management of children with FTT entails intervention as indicated for pathologic conditions contributing to undernutrition.

• Developmental and behavioral — Developmental and behavioral problems may contribute to inadequate intake (eg, oral motor dysfunction) or increased losses (eg, rumination). 

OTHER INTERVENTIONS• Psychosocial — The  primary  goal  for improved  nutrition  must  be  accompanied by  addressing  the  psychosocial difficulties.  Effective  treatment,  whether inpatient  or  outpatient,  requires involvement  and  support  of  the caretakers.

References