Failure to Thrive

By Medically reviewed by hellodoktor


What is failure to thrive?

Failure to thrive refers to children whose current weight or rate of weight gain is much lower than that of other children of similar age and gender. Most kids steadily gain weight and grow quickly within the first few years of life. But in some cases, kids don’t meet these expected standards of growth. In general, kids who fail to thrive don’t receive or cannot take in, keep, or use the calories that would help them grow and gain enough weight. Most babies double their birth weight by 4 months and triple it by age 1, but kids who fail to thrive usually don’t meet those milestones. Sometimes, a child who starts out “plump” and seems to be growing well may gain less weight later. After a while, height growth may slow as well.

How common is failure to thrive?

Failure to thrive is extremely common. It can occur in patients in any gender at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Which signs and symptoms can failure to thrive usually be associated with?

Related signs and symptoms include:

  • Lack of weight gain
  • Delays in reaching developmental milestones such as rolling over, crawling, and talking
  • Learning disabilities
  • Lack of emotions such as smiling, laughing, or making eye contact
  • Delayed motor development
  • Fatigue
  • Irritability
  • Delayed puberty in teens


What causes failure to thrive?

Causes of failure to thrive can include:

  • Not enough food offered. In some cases, parents mistakenly cause the problem. Sometimes a parent measures formula incorrectly, causing an infant to get too few calories. Problems with breastfeeding or transitioning to solids also can cause failure to thrive. Parents who worry their child will get fat may restrict the amount of calories they give their infants. And sometimes parents don’t pay enough attention to their children’s hunger cues or can’t afford enough food for their children.
  • The child eats too little. Some children have trouble eating enough food because of prematurity, developmental delays, or conditions like autism in which they do not like eating foods of certain textures or tastes.
  • Health problems involving the digestive system. Several health conditions can prevent a child from gaining weight. These include gastroesophageal reflux (GER), chronic diarrhea, cystic fibrosis, chronic liver disease, and celiac disease.With reflux, the esophagus may become so irritated that a child refuses to eat because it hurts. Persistent diarrhea can make it hard for the body to hold on to the nutrients and calories from food. Cystic fibrosis, chronic liver disease, and celiac disease all cause problems with the body’s ability to absorb nutrients. The child may eat a lot, but the body doesn’t absorb and retain enough of that food. Kids with celiac disease are allergic to gluten, a protein found in wheat and other grains. The immune system’s abnormal response to this protein damages the lining of the intestine so it can’t absorb nutrients properly.
  • Food intolerance. A food intolerance, which is different from a food allergy, means the body is sensitive to certain foods. For example, milk protein intolerance means the body can’t absorb foods that have milk proteins, such as yogurt and cheese, which could lead to failure to thrive.
  • An ongoing illness or disorder. A child who has trouble eating — because of prematurity or a cleft lip or palate, for example — may not take in enough calories to support normal growth. Other conditions involving the heart, lungs, or endocrine system can increase the amount of calories a child needs and make it hard for the child to eat enough to keep up.
  • Parasites, urinary tract infections (UTIs), tuberculosis, and other infections can force the body to use nutrients rapidly and decrease appetite. This can lead to short- or long-term failure to thrive.
  • Metabolic disorders. Metabolic disorders are health conditions that make it hard for the body to break down, process, or take energy from food. They also can cause a child to eat poorly or vomit.

Sometimes a mix of medical problems and environmental factors leads to failure to thrive. For instance, if a baby has severe GER and is reluctant to eat, feeding times can be stressful. The baby may become upset and frustrated, and the caregiver might be unable to feed the child enough food.

Other times, doctors aren’t sure exactly what causes the problem.

The conditions mentioned above are some common causes of failure to thrive. Consult with your doctor for an accurate diagnosis.

Risk factors

What increases my risk for failure to thrive?

Risk factors for a child failing to thrive include underlying conditions, such as:

  • Down syndrome
  • Cerebral palsy
  • Heart disease
  • Infections
  • Milk allergy
  • Cystic fibrosis
  • Celiac disease
  • Acid reflux

Children who have serious medical problems during the early years of their life can develop FTT. Children who are born prematurely and have low birth weight may also fail to thrive.

Other risk factors include:

  • Poor nutrition
  • Poor feeding habits
  • Neglect
  • Physical abuse
  • Mental trauma
  • Mental disorders, such as depression
  • Environmental factors, such as poverty

Please consult with your doctor for further information.

When to see your doctor

When should I see my doctor?

Many babies go through brief periods when their weight gain levels out, or they even lose a little weight. This is not unusual. However, if a baby doesn’t gain weight for 3 months in a row during the first year of life, it could be a problem.

If you notice a drop in weight gain or your baby doesn’t seem to have a normal appetite, call your doctor. Also call about any major change in eating patterns. Toddlers and older kids may have days and sometimes weeks when they show little interest in eating, but that shouldn’t happen in infants.

If you have trouble feeding your baby, your doctor can help. When a child doesn’t readily eat, parents can become frustrated and feel they’re doing something wrong. That can make the problem worse, causing stress for you and your baby. Instead, get help for both of you by talking to your doctor.

On noticing one of these symptoms or having any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor to get the best solutions for your situation.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage failure to thrive?

These following lifestyles and home remedies might help you cope with failure to thrive:

  • Proper feeding can be achieved through infant formulas that are adjusted to meet the child’s specific nutrient needs. Infants may be given concentrated formulas, assuming their kidney function is normal. In cases of kidney disorders, increasing the fat content of the formula may be useful as a way of delivering additional calories.
  • Older children with FTT may benefit from adding cheese, sour cream, butter, margarine, or peanut butter to meals.
  • High-calorie shakes can be used to supplement meals.
  • Multivitamin and mineral supplements, including iron and zinc, usually are recommended to all undernourished children.

If you have any questions, please consult with your doctor for the best solutions.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: February 15, 2019 | Last Modified: September 12, 2019

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