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Am Fam Physician. 2011;83(7):837-838

See related article on failure to thrive.

What is failure to thrive?

The words “failure to thrive” are used to describe a child who is growing more slowly than other children the same age.

What causes it?

A child with failure to thrive is not getting enough calories to grow. The most common cause is not eating enough food. Some reasons a child may not be getting enough food include:

  • Feeding problems, like poor sucking or swallowing

  • Trouble with breastfeeding

  • Drinking too much juice, which has a lot of sugar but not enough nutrients needed for proper growth

  • Trouble switching from formula to solid food

  • Not enough high-calorie foods in the diet

  • Family problems that affect the diet

Sometimes a child may burn more calories than he or she eats because of a serious medical problem such as heart or lung disease. Having a lot of diarrhea or vomiting may also cause failure to thrive.

How do I know if my child has a problem?

Your doctor will examine your child. He or she may ask about how you feed your child. It may help to show the doctor how you breastfeed or how you make your child's bottles. If your child is older, your doctor may ask you for a list of everything your child eats or drinks each day (called a food journal). Sometimes, your doctor may suggest blood work or other tests.

What happens if my child has failure to thrive?

Often, failure to thrive is treated by increasing the amount of food in your child's diet. If you are breastfeeding, talk to your doctor about the right way to do it. If you feed your child formula, talk to your doctor about ways to increase the amount of calories in the formula. If your child is older, he or she may need a special food supplement. Be sure to give your child three meals a day, and offer healthy snacks between meals.

If you do not have enough money, you may be able to get food for your child through a service called WIC (Women, Infants, and Children) or through the food stamp program. Tell your doctor if you need help signing up for these programs.

Other health care professionals, such as a dietitian or a breastfeeding specialist, may help with treatment. Your child will also need to be weighed often to keep track of changes in growth.

If your child has a medical condition that causes failure to thrive, treating that condition may help your child grow. Sometimes, a child may need to stay in the hospital, but usually only if the child starts losing weight or does not gain weight with treatment.

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