Failure to Thrive
Failure to thrive is the term used to describe the condition where an infant or child does not gain weight, grow or develop as it should. During intra-uterine life, provided the pregnancy is normal and the placenta functions properly, a foetus is fed continuously and enjoys the luxury of not having to make any effort to breathe or keep itself warm. Immediately after birth it has to start doing both these things and at the same time its intravenous food supply is rudely cut off, which is why newborn babies commonly lose weight straight after birth. Monitoring weight gain thereafter is important. The use of centile charts is invaluable, since it gives us an early warning about disturbed growth patterns. (A centile chart consists of a series of plots representing patterns of growth for different percentages of the population. The plot in the middle, called the 50th centile, represents the average, so that 50 per cent will be larger and 50 per cent smaller. The one at the top, called the 97th centile, means that only three per cent of the population will be larger. The one at the bottom, called the 3rd centile, means that only three per cent will be smaller. There are charts available for height, weight and head circumference at different ages. Failure to thrive means that a child has started off on one centile and over a period time has dropped down two significant centiles. There are very many different causes. Any severe illness such as congenital heart disease, cystic fibrosis or bad asthma will interfere with development, so that a child who is failing to thrive needs investigation, treatment of any underlying condition and nutritional support. Not all failure to thrive is due to physical disorder - emotional and physical security are also involved in normal development. Unhappy adults tend to eat for comfort, while unhappy infants tend to shrink.
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