Failure to Thrive In Infants

Failure to thrive in infants is characterized by abnormally low rate of weight gain and delayed physical growth of the child, leading to development delays. It adversely affects the physical and mental maturation of the child.

  • Malnutrition or certain medical disorders occurring in children is the usual cause of failure to thrive in most cases.
  • Failure to thrive is determined by comparing the growth chart of the child, a thorough physical examination, and the feedback from parents regarding the health and growing environment of the child.
  • Malnutrition and undernourishment in the first year of the child’s life may result in developmental delays in the child.
  • Failure to thrive is treated by treating the underlying cause of the condition.

Children who are underweight consistently, and fail to gain weight normally for no apparent reason, are regarded as having the condition referred to as failure to thrive.  The underlying reason for this condition may vary between individual cases. The growing environment of the child and other social factors may be keeping the child from receiving necessary nutritional inputs, affecting the child’s normal growth and development. In some cases, certain medical disorders occurring in the child may retard the normal developmental pace.

Many less-than-ideal family situations and social conditions may be responsible for malnourishment in the child. In unstable families, the absence of proper mealtimes and nutritious meals may affect the appetite of the child and considerably reduce its food intake. Mental disorders and abusive habits in the parents may result in neglect and abuse of the child, preventing its normal growth. Poor financial status of the family may be causing inadequate food supply and affecting the nutritional quality of the food available. Lack of environmental stimulation may adversely affect the physical and mental development of the child.

In some cases, the failure to thrive in infants may be due to a disease or a medical disorder present in the child. A physical defect such as cleft palate, or cleft lip, may be interfering with feeding, due to which the child fails to receive enough nourishment. Other disorders which may result in malnutrition include gastroesophageal reflux, physical abnormalities such as a malabsorptive syndrome, or narrowing of the esophagus. Certain tumors and infections in the child, hormonal insufficiencies, heart disease, metabolic disorders like diabetes, cystic fibrosis, and kidney disease, are a few of the other medical reasons for growth retardation. HIV infection and some genetic disorders also may be responsible for the failure to thrive.


When the child’s rate of growth has been steady even if it is lower than the standard growth rate of children of the same age, the child is assessed to be small for its age, but growing normally.  However, when the child’s growth chart shows reduced weight gain and retarded growth when it is compared to the previous records, the doctor may suspect failure to thrive, especially if no specific medical cause for the growth retardation can be identified.

The reason for the failure to thrive in infants is investigated by asking the parents about the child’s feeding habits, bowel movements and illnesses. The financial status of the parents and other social conditions and family atmosphere which may interfere with the child’s nutritional intake are discussed, and assessed, to determine the underlying cause of malnourishment. The doctor may try to detect any specific disease in the child, or any disorder which runs in the family, by questioning the parents and examining the child thoroughly. Blood tests, urine tests and x-rays may be conducted if the doctor feels that further investigations are necessary to identify the possible medical cause for the failure to thrive.


If a child is malnourished in the first year of its life, it may result in permanent damage to the physical and mental well being of the child. Optimal nutrition is essential for brain development, and nutritional deficiencies, especially in the first year, may precipitate irreversible damage. With timely medical intervention, the child may recover physically in most cases, and may continue to grow normally, with better nutritional inputs. However, their mental development may lag behind; their verbal skills may remain lower than normal; they may have emotional and social problems as well.


Failure to thrive in infants is treated mainly by treating or removing the root cause of the condition. If the child is diagnosed with any medical disorder which may be affecting normal growth and development, it is treated appropriately. By comparing the weight gain of the child with that of children of the same age, it is possible to determine how abnormally low the child’s weight is. If the failure to thrive is found to be mild or moderate, a high calorie nutritious diet and a regular feeding schedule may help the child recover. The financial and social conditions of the parents may be analyzed to see whether they could be affecting the child’s nutritional intake. Parents are counseled about providing an environment conducive to the normal growth and development of the child. If the failure to thrive is found to be severe, the child may need hospitalization and intensive treatment. A panel of specialists, including psychiatrists, nutritionists, behavioral therapists and social workers, may have to collaborate to find the possible reasons for the condition and to determine ways and means to tackle it.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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