1. Running Head: FAILURE TO THRIVE? 1
Failure to Thrive?
Lesson 3.2
St. Joseph’s College of Maine
2. FAILURE TO THRIVE? 2
Initially, the clinician should review the birth weight with an understanding that she was
born at 36 weeks gestation, know as a late preterm birth to an adolescent mother. Most
importantly, a review of BMI for age, to determine if it is less than the 5th percentile, and weight
less than 75 percent of median weight for length should be determined. This infant does fall
below the weight for length percentiles, just below or at 2% according to WHO, (Kirkland &
Motil, 2014). Weight velocity unfortunately cannot be calculated as there are no weights
available since the 2 week visit (Cole & Lanham, 2011). Failure to thrive can be a broadly used
term to describe a child whose current weight or trajectory of weight gain does not equal that of
other children of similar age, gender and ethnicity (Stephens, Gentry, Michener & Kendall,
2008). According to the CDC, FTT includes children who drop more than two standard
percentile lines on growth charts, are below the 3rd percentile for weight, have weight for length
less than 80% of ideal weight, have height or weight less than a 3rd percentile, and have weight
for height less than a 10th percentile or weight for age less than two standard deviations below
the mean for age. More than 80% of children with poor growth do not have an underlying
medical disorder, so a careful history of feeding patterns, appetite, daily intake, types of foods
and amount of activity should be pursued. Failure to thrive without an underlying medical
disorder represents a disruption in the biological, psychosocial, and environmental factors that
contribute to a child's growth and development (Kirkland & Motil, 2014).
History questions first and foremost should include feedings, amount taken, type of
formula, and if there is any regurgitation. It is unlikely that this mother is breast-feeding, as she
is attending school, so formula mixing techniques should be questioned and reviewed. A
psychosocial history which involves the caretakers understanding of how often to feed the infant
and how much the infant should be taking at this stage of development is crucial.
