cu 7 module version

• Failure to Thrive (FTT) is a term used to describe a child whose weight falls below the 5th percentile on a standardized growth chart; growth measurements in addition to a persistent deviation from an established growth curve is generally a cause for concern
• Sudden infant death syndrome is defined as the sudden death of an infant younger than 1 year of age that remains unexplained after a complete postmortem examination
• Failure to Thrive


  • Inadequate caloric intake
  • Inadequate absorption
  • Increased metabolism
  • Defective utilization
• Causes of Failure to Thrive

  • Incorrect formula preparation
  • Neglect
  • Food fads
  • Excessive juice consumption
  • Poverty
  • Breastfeeding problems
  • Behavioral problems affecting eating
  • Central nervous system problems affecting intake
  • Cystic fibrosis
  • Celiac disease
  • Vitamin or mineral deficiencies
  • Biliary atresia
  • Hepatic disease
  • Hyperthyroidism
  • Congenital heart disease
  • Chronic immunodeficiency
  • Genetic anomaly
  • Congenital infection
  • Metabolic storage diseases
• Infants who are born preterm and with VLBW or ELBW, as well as those with intrauterine growth restriction (IUGR), are often referred for growth failure within the first 2 years of life because they typically do not grow physically at the same rate as term cohorts even after discharge from the acute care facility
• Diagnosis of Failure to Thrive

  • Evidence of growth failure
  • Complete health and dietary history
  • Physical examination
  • Developmental assessment
  • Family assessment
  • Dietary intake history
• Management of Failure to Thrive

  1. Reverse the cause of the growth failure

  2. Provide sufficient calories to support "catch-up" growth

  3. Add caloric density to feedings

  4. Provide multivitamin supplements

  5. Provide dietary supplementation with high-calorie foods and drinks

  6. Treat any coexisting medical problems

  7. Provide a positive feeding environment

  8. Teach the parents successful feeding strategies

  9. Support the child and family
• Goals in Nutritional Management of Failure to Thrive

  • Correct nutritional deficiencies and achieve ideal weight for height
  • Allow for catch-up growth
  • Restore optimum body composition
  • Educate the parents or primary caregivers regarding the child's nutritional requirements and appropriate feeding methods
• Colic


  Abdominal pain or cramping that is manifested by loud crying and drawing the legs up to the abdomen
• Characteristics of Colic


  • More common in infants younger than 3 months
  • Infants with difficult temperaments are more likely to be colicky
  • Infant with colic gains weight and usually thrives
  • Colic is self-limiting and in most cases resolves as infants mature, generally around 12 to 16 weeks of age
• Potential Causes of Colic

  • Too rapid feeding
  • Overeating
  • Swallowing excessive air
  • Improper feeding technique
  • Emotional stress or tension between the parent and child
• Management of Colic


  1. Investigate possible organic causes

  2. Reassure parents

  3. Take a thorough, detailed history

  4. Assess the feeding process
• Colic disappears spontaneously, usually by 3 to 4 months of age, although guarantees should never be given, since it may continue for much longer
• Sudden Infant Death Syndrome (SIDS)


  • Brainstem abnormality in the neurologic regulation of cardiorespiratory control
  • Maternal smoking during pregnancy
  • Tobacco smoke in the infant's environment after birth
  • Co-sleeping or an infant sharing bed with an adult or older sibling on a non-infant bed
  • Prone sleeping
  • Soft bedding
  • Head covering by a blanket
• Exclusive breastfeeding for any period of time decreased the overall risk of SIDS
• Pacifier use in infants in the first year of life may be a protective factor against the occurrence of SIDS
• Infants at Increased Risk for SIDS

  • Low birth weight
  • Low Apgar scores
  • Recent viral illness
  • Siblings of two or more SIDS victims
  • Male sex
  • Infants of American Indian or African American ethnicity
• Nursing Care Management for SIDS

  1. Educate families about the risk of prone sleeping position

  2. Educate about the use of appropriate bedding surfaces

  3. Educate about the association with maternal smoking

  4. Educate about the dangers of co-sleeping

  5. Promote modeling behaviors for parents to foster practices that decrease the risk of SIDS