FAILURE TO THRIVE

• Growth failure is a sign of inadequate growth resulting from an inability to obtain or use calories required for growth.
• ORGANIC FTT

  secondary to underlying medical illnesses
• NON-ORGANIC FTT (NFTT)

  psychosocial FTT, no known medical condition that causes poor growth, inadequate food or nutrition
• MIXED FTT

  organic and non organic causes coexist
• Inadequate caloric intake

  Incorrect formula preparation, neglect, food fads, excessive juice consumption, poverty, breastfeeding problems, behavioral problems affecting eating, or central nervous system problems affecting intake
• Inadequate absorption

  Cystic fibrosis, celiac disease, vitamin or mineral deficiencies, biliary atresia, or hepatic disease
• Increased metabolism

  Hyperthyroidism, congenital heart disease, hyperthyroidism, or chronic immunodeficiency
• Defective utilization

  Genetic anomaly such as trisomy 21 or 18, congenital infection, or metabolic storage diseases
• A dietary intake history, either a 24-hour food intake or a history of food consumed over a 3- to 5-day period, is also essential.
• FOUR PRIMARY GOALS IN THE NUTRITIONAL MANAGEMENT OF CHILDREN WITH FTT ARE TO:

  • correct nutritional deficiencies and achieve ideal weight for height
  • allow for catch-up growth
  • restore optimum body composition;
  • and educate the parents or primary caregivers regarding the child’s nutritional requirements and appropriate feeding methods
• Colic is a condition generally described as abdominal pain or cramping that is manifested by loud crying and drawing the legs up to the abdomen.
• "Rule of Three" - inconsolable crying that lasts more than three hours a day and occurs more than three days a week for at least three weeks.
• Formula-fed infants are more likely to have colic than breastfed infants
• • The baby's face is red, and the skin around the mouth is pale.
  • The belly is bulging and hard.
  • The legs are drawn into the belly, and the feet are cold. (The legs can also be straight out when the baby cries especially hard.)
  • The fingers are clenched shut.
  • The arms are stiff, tight, and straight. (The elbows can also be bent.)
  • The back is arched.
• 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
• Sudden unexpected early neonatal death (SUEND)
• Maternal smoking

  during pregnancy has emerged in numerous epidemiologic studies as a major factor in SIDS, and tobacco smoke in the infant’s environment after birth has also been shown to have a possible relationship to the incidence of SIDS.
• Cosleeping

  or an infant sharing a bed with an adult or older child on a noninfant bed, has been reported to have a positive association with SIDS
• Prone sleeping

  may cause oropharyngeal obstruction or affect thermal balance or arousal state. Rebreathing of carbon dioxide by infants in the prone position is also a possible cause of SIDS.

  Infants sleeping prone and on soft bedding may not be able to move their heads to the side, thus increasing the risk of suffocation and lethal rebreathing