Pediatr Gastroenterol Hepatol Nutr.  2013 Dec;16(4):261-268.

Clinical Characteristics of Failure to Thrive in Infant and Toddler: Organic vs. Nonorganic

• Yoo SD
• Hwang EH
• Lee YJ
• Park JH

Abstract

PURPOSE
To investigate the clinical characteristics and outcomes among infants and toddlers with failure to thrive (FTT).
METHODS
This retrospective study was done with 123 patients who had visited Pusan National University Children's Hospital during their first two years of life and had received an FTT diagnosis. We compared the clinical characteristics of the patients based on the causes of their FTT and their ages at the time of first hospital visit. We investigated triggering factors, feeding practices, and outcomes in 25 patients with nonorganic FTT (NOFTT).
RESULTS
Eighty cases (65.0%) were NOFTT. The gestational ages, birth weights, and weights at the first visits were significantly lower in patients with organic FTT (OFTT) (p<0.05). Infants who had first visited the clinic at age <6 months had the least z-score. The percentage of patients with severe weight decline was higher in OFTT than in NOFTT (60.0% vs. 17.3%). The z-scores at the follow-up visits were improved after treatment in both of the groups. Preceding infection was the most common triggering factor of NOFTT and persecutory feeding as abnormal behavior of caregiver was observed in 22 cases (88.0%). After treatment with feeding method modification, all patients with NOFTT showed normal growth.
CONCLUSION
Weight decline is more severe in OFTT patients and in younger patients at the first visit. Infants with FTT can attain normal weight gain growth by treating organic diseases and supplying proper nutrition in OFTT, and by correcting abnormal dietary behavior of caregiver in NOFTT.

Keyword

Failure to thrive; Infant

MeSH Terms

Birth Weight
Busan
Caregivers
Diagnosis
Failure to Thrive*
Feeding Methods
Follow-Up Studies
Gestational Age
Humans
Infant*
Methods
Retrospective Studies
Weight Gain
Weights and Measures

Figure

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  Fig. 1 Changes of z-score of weight at birth, first visit and follow-up visit in patients with organic and nonorganic failure to thrive. There was marked decline of z-score at first visit in organic failure to thrive (p<0.001) and improvement of z-score in both groups at follow-up visit, especially in organic failure to thrive (p=0.037).

• 

  Fig. 2 Changes of z-score of weight at birth, first visit and follow-up visit according to age group. There was marked decline of z-score in the patients whose age at first visit was less than 6 months (p<0.001). The patients of this group showed also significant improvement of z-score at follow-up visit (p=0.017).

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