Failure to thrive is defined as a significant interruption in the expected rate of growth during early childhood. It affects 5-10% of children and is often seen before 18 months of age. It can be classified as organic (medical causes) or non-organic (social/environmental causes). Treatment involves identifying and treating the underlying cause, ensuring adequate caloric intake, and utilizing an interdisciplinary team approach with pediatricians, nutritionists, and social workers. Early intervention programs that include home visits have been shown to improve growth outcomes and reduce behavioral problems in children with a history of failure to thrive.
Failure to thrive (FTT) refers to inadequate growth in infants and children. It is defined as weight below the 3rd percentile on a growth chart or a significant drop off from a previously established growth curve. FTT can be organic, resulting from medical causes like prematurity or malnutrition, or inorganic, caused by non-medical factors like poor parenting or neglect. Evaluation involves a thorough history, physical exam, and basic lab tests. Treatment focuses on identifying and addressing the underlying cause while ensuring adequate calorie intake through increased feeding or supplementation. Early diagnosis and intervention are important to prevent long term developmental and health impacts of prolonged malnutrition.
Failure to thrive (FTT) is a descriptive term used for infants and children under 3 years whose growth is significantly less than peers. It can be organic (20-30%) due to medical causes, or nonorganic (70-80%) due to environmental factors. Evaluation of a child with FTT involves obtaining a thorough history, physical exam, anthropometry, and investigations if needed to rule out organic causes. Management focuses on improving the child's diet and eating patterns, developmental stimulation, enhancing the caregiver's skills, treating any underlying diseases, and regular follow-up to monitor the effectiveness of nutritional therapy.
FAILURE TO THRIVE CHILDREN ETIOLOGY AND MANAGEMNT.pptxneeti70
Failure to thrive (FTT) describes inadequate weight gain in children and can be caused by organic medical issues, inadequate calorie intake, or both. Left untreated, FTT can cause stunted growth and developmental delays. A thorough history and physical exam is needed to determine the underlying cause, such as feeding difficulties, oral issues preventing eating, gastrointestinal problems, or increased caloric needs from other illnesses. Treatment involves nutritional and feeding strategies, monitoring weight gain, and addressing any organic medical conditions found.
Approach to a child with failure to thriveSingaram_Paed
This document discusses failure to thrive (FTT) in children. It defines FTT as inadequate physical growth compared to peers. FTT can be caused by inadequate calorie intake, absorption, increased needs, or utilization. It affects 5-10% of young children. Causes include psychosocial factors, infections, gastrointestinal issues, and neurological problems. Evaluation of a child with FTT involves medical history, physical exam, lab tests, and assessing nutrition. Treatment focuses on improving the child's diet and development stimulation, caregiver skills, and treating any underlying medical issues. Regular follow up is also important.
This document discusses counseling families on common early childhood concerns including sleep issues, thumb-sucking, picky eating, school readiness, and oral health. It provides evidence-based recommendations on these topics. For example, it recommends behavioral interventions for sleep issues after 6 months of age and positive reinforcement to address thumb-sucking. The document also stresses the importance of reading to young children to promote literacy and enrolling children in quality preschool. Overall, the document aims to educate families on addressing normal developmental variations and when to seek help for issues that could impact future health.
Failure to thrive children and its managemnt.pptxneeti70
Failure to thrive (FTT) is defined as inadequate weight gain in pediatric patients, measured as weight below the 5th percentile or a significant drop in weight percentiles. Left untreated, FTT can cause stunted growth and developmental delays. FTT is often due to inadequate caloric intake from inorganic causes like improper feeding or lack of parental knowledge, though it may also be caused by organic medical issues or increased caloric demand from underlying conditions. Evaluating FTT involves taking a thorough history including feeding patterns and psychosocial factors, followed by physical exam and potential lab tests or nutritional interventions to support weight gain.
This document discusses failure to thrive in children. It begins by defining failure to thrive as inadequate nutrition leading to abnormal growth. Growth charts are then reviewed as tools to identify failure to thrive. The causes of failure to thrive are categorized as inadequate calories, inability to utilize calories, and increased caloric needs. Child abuse, including neglect, medical child abuse, and physical/sexual abuse, are also discussed as potential causes. The evaluation, treatment, and multidisciplinary management of failure to thrive are outlined.
Failure to thrive (FTT) refers to inadequate growth in infants and children. It is defined as weight below the 3rd percentile on a growth chart or a significant drop off from a previously established growth curve. FTT can be organic, resulting from medical causes like prematurity or malnutrition, or inorganic, caused by non-medical factors like poor parenting or neglect. Evaluation involves a thorough history, physical exam, and basic lab tests. Treatment focuses on identifying and addressing the underlying cause while ensuring adequate calorie intake through increased feeding or supplementation. Early diagnosis and intervention are important to prevent long term developmental and health impacts of prolonged malnutrition.
Failure to thrive (FTT) is a descriptive term used for infants and children under 3 years whose growth is significantly less than peers. It can be organic (20-30%) due to medical causes, or nonorganic (70-80%) due to environmental factors. Evaluation of a child with FTT involves obtaining a thorough history, physical exam, anthropometry, and investigations if needed to rule out organic causes. Management focuses on improving the child's diet and eating patterns, developmental stimulation, enhancing the caregiver's skills, treating any underlying diseases, and regular follow-up to monitor the effectiveness of nutritional therapy.
FAILURE TO THRIVE CHILDREN ETIOLOGY AND MANAGEMNT.pptxneeti70
Failure to thrive (FTT) describes inadequate weight gain in children and can be caused by organic medical issues, inadequate calorie intake, or both. Left untreated, FTT can cause stunted growth and developmental delays. A thorough history and physical exam is needed to determine the underlying cause, such as feeding difficulties, oral issues preventing eating, gastrointestinal problems, or increased caloric needs from other illnesses. Treatment involves nutritional and feeding strategies, monitoring weight gain, and addressing any organic medical conditions found.
Approach to a child with failure to thriveSingaram_Paed
This document discusses failure to thrive (FTT) in children. It defines FTT as inadequate physical growth compared to peers. FTT can be caused by inadequate calorie intake, absorption, increased needs, or utilization. It affects 5-10% of young children. Causes include psychosocial factors, infections, gastrointestinal issues, and neurological problems. Evaluation of a child with FTT involves medical history, physical exam, lab tests, and assessing nutrition. Treatment focuses on improving the child's diet and development stimulation, caregiver skills, and treating any underlying medical issues. Regular follow up is also important.
This document discusses counseling families on common early childhood concerns including sleep issues, thumb-sucking, picky eating, school readiness, and oral health. It provides evidence-based recommendations on these topics. For example, it recommends behavioral interventions for sleep issues after 6 months of age and positive reinforcement to address thumb-sucking. The document also stresses the importance of reading to young children to promote literacy and enrolling children in quality preschool. Overall, the document aims to educate families on addressing normal developmental variations and when to seek help for issues that could impact future health.
Failure to thrive children and its managemnt.pptxneeti70
Failure to thrive (FTT) is defined as inadequate weight gain in pediatric patients, measured as weight below the 5th percentile or a significant drop in weight percentiles. Left untreated, FTT can cause stunted growth and developmental delays. FTT is often due to inadequate caloric intake from inorganic causes like improper feeding or lack of parental knowledge, though it may also be caused by organic medical issues or increased caloric demand from underlying conditions. Evaluating FTT involves taking a thorough history including feeding patterns and psychosocial factors, followed by physical exam and potential lab tests or nutritional interventions to support weight gain.
This document discusses failure to thrive in children. It begins by defining failure to thrive as inadequate nutrition leading to abnormal growth. Growth charts are then reviewed as tools to identify failure to thrive. The causes of failure to thrive are categorized as inadequate calories, inability to utilize calories, and increased caloric needs. Child abuse, including neglect, medical child abuse, and physical/sexual abuse, are also discussed as potential causes. The evaluation, treatment, and multidisciplinary management of failure to thrive are outlined.
This document discusses failure to thrive and short stature in children. It defines failure to thrive as inadequate calorie intake to support a child's growth and metabolic demands, resulting in growth failure. Causes of failure to thrive include inadequate nutrition from medical issues, psychosocial factors, or increased calorie expenditure from illness or disease. The assessment and management of failure to thrive involves detailed history, examinations to identify underlying causes, nutritional rehabilitation, parental counselling, and medical treatment. Short stature is defined as height below the 3rd percentile or 2 standard deviations below the mean for age and sex. The document discusses normal growth velocity and the determinants of child growth.
The document discusses health, illness, and disease across the lifespan from childhood to older adulthood. Key points include:
- Children's health is influenced by timely immunizations, accidents being a leading cause of death, and caregivers playing an important role. Poor health is also an issue for children in low-income families.
- Adolescence is a critical time for adopting health behaviors, with social contexts like families and peers being influential. Emerging adults have higher mortality rates than adolescents and may not consider how behaviors affect later health.
- Chronic illnesses become more common with age, with cancer and cardiovascular disease being leading causes of death. Alzheimer's and Parkinson's diseases are also discussed as forms of dementia that
Failure to thrive, or FTT, refers to inadequate growth and development in infants and children. A thorough evaluation of the child is needed to determine if FTT has an organic medical cause or is due to non-organic psychosocial factors. Laboratory investigations and nutritional management are important for diagnosis and treatment. The prognosis depends on the underlying cause, with organic causes having more variable outcomes depending on the specific condition, while psychosocial FTT can be associated with lasting developmental delays if not properly addressed.
Malnutrition is a major problem in India with multiple causes and serious consequences. It affects people of all ages but particularly impacts children under 5. Common causes of malnutrition in India include lack of food due to poverty, lack of nutrition education, and illnesses that decrease appetite or ability to absorb nutrients. Malnutrition can cause weight loss, fatigue, reduced growth in children, and increased risk of illness and death. Prevention strategies focus on breastfeeding, nutritional supplements, food fortification, and increasing access to nutritious foods.
This is an undergraduate presentation on failure to thrive in Pediatrics. In this presentation I mentioned about Diagnosis, Etiology, Etiology, Diagnostic Evaluation and Management.
https://orcid.org/0000-0001-9306-2267
https://1drv.ms/p/s!Am9GQ5GMX-WyjmOfgcNpov4RewVL
Pamudith Karunaratne
Failure to thrive malnutrition paedia . pptxAasthaPawar4
Failure to thrive is a disorder where infants and children do not gain weight or may lose weight at an expected rate. It is defined as weight being below the 3rd percentile on a growth chart or weight gain less than 20g/day from birth to 3 months or 15g/day from 3-6 months. Failure to thrive can be organic due to medical causes, inorganic due to non-medical causes like poor parenting, or mixed. Causes include inadequate calorie intake, absorption issues, increased calorie needs, excessive calorie loss, or altered growth regulation. Assessment involves a physical exam, growth chart, and lab tests. Management focuses on correcting underlying issues, improving nutrition and caregiving, and follow up to support catch
Failure to thrive is defined as sustained weight loss or failure to gain weight resulting in a child's weight falling below normal growth curves. It can be caused by inadequate nutrition intake, increased calorie needs, or issues with absorption. Evaluation involves assessing growth charts, nutrition intake, physical exam for signs of organic disease, and laboratory tests if indicated. Management goals are nutritional rehabilitation, treating any underlying medical causes, and addressing psychosocial factors. The prognosis depends on the etiology, with psychosocial causes having risks of developmental delays and organic causes having variable outcomes based on the specific condition.
The document discusses nutrition in preschool children ages 1-6. Key points include:
- Growth rates decrease in preschoolers, leading to less appetite and intake.
- Common nutritional problems are protein-energy malnutrition, iron-deficiency anemia, vitamin A deficiency, and iodine deficiency.
- Nutrient needs include adequate energy, protein, vitamins, minerals, and micronutrients for growth and development.
- Factors like family environment, media, illness can influence children's food intake. Feeding problems may occur and require intervention.
Constipation is a common gastrointestinal issue in children. It can be functional or organic in nature, with functional constipation making up the majority of cases. The document discusses the definition, epidemiology, risk factors, evaluation, and management of pediatric constipation. Evaluation involves history, physical exam, and potential imaging and testing. Management is multi-pronged, focusing on education, dietary changes, behavioral modifications, disimpaction if needed, and long-term maintenance therapy often involving laxatives. Surgery is rarely needed and reserved for severe, refractory cases. Childhood constipation can sometimes predict irritable bowel syndrome in adulthood.
This document outlines a lecture on child and preadolescent nutrition. It discusses normal growth and development in children, including adiposity rebound. It also covers energy and nutrient needs, common nutrition problems like iron deficiency and dental caries, and childhood obesity including predictors, assessment, and treatment approaches. The goal of obesity treatment is weight maintenance or gradual weight loss until a healthy BMI is achieved.
INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES.pptxgrace471714
This document discusses integrated management of childhood illnesses (IMCI), an approach developed by WHO and UNICEF to reduce child morbidity and mortality in developing countries. It focuses on improving health worker case management skills, strengthening health systems, and promoting family/community practices. The main causes of death in children under 5 are pneumonia, diarrhea, malaria, measles, and malnutrition. IMCI aims to classify and treat these illnesses early through integrated care. It uses charts to guide health workers through assessment, classification, treatment, counseling and follow-up. IMCI also promotes preventive measures, growth monitoring, and encourages communities to seek timely care.
Determinants of Eating Behavior and its Impact on Chronic Diseases.pptxWajid Rather
S-1 Prevalence of Chronic disease in India
S-2 Percentage of Hypertension in Indians
S-3 Percentage of Hypertension in Indians
S-4 Percentage of overweight Indians
S-6 Chronic diseases share
common risk factors and conditions
S-7 Major Factors Influence Our Eating Behavior
S-8 Portion sizes
S-9 Informational Eating Norms
S-10 Family and Social Determinants
S-11 Environmental Influences on eating Behaviour
S-12 Parental Influences on on children's Eating pattern and Food Choices
S-13 Eating Disorders
S-14 Types of Eating Disorders
S-15 Health Effects of Different Types of Eating Disorders
S-16-18 Diagnostic Consideration for Different types of Eating Disorders
S-23 Different Treatment Options for eating Disorders
S-24-27 Nutritional Assessment, Intervention and Nutrition Monitoring and Evaluation
Determinants of Eating Behavior and its impact on chronic Diseases.pdfWajid Rather
Slide no 1: Determinants of Eating Behavior and its Impact on Chronic Diseases
Slide -2 Prevalence of Chronic Diseases in India
Slide-3 Percentage of Hypertension in Indians
Slide-4 Percentage of Overweight Indians
Slide-5 Chronic Disease share common Risk factors and Conditions
Slide-6 Major Factors influence our Eating Behaviour and Food Choices
Slide-7 Portion Sizes
Slide-8 Information Eating Norms
Slide-9 Social Determinants
Slide-10 Environmental Influence on Children's Eating and Food Choices
Slide-11 Parental Influences on Children Eating and Food Choices
Slide-12 Eating Disorders
slide-13 Types of Eating Disorders
Slide-14 Health Effects of Different types of Eating Disorders
Slide -15 Diagnostic Consideration for different Eating Disorders
Slide-16 Treatment options for Eating Disorders
Slide -17 Nutrition Assessment
slide-18 Nutrition Intervention
Slide -19 Nutrition Monitoring and Evolution
1) The document discusses nutrition needs and eating behaviors for children from toddlerhood through adolescence.
2) Key nutrient needs include adequate calories, protein, calcium, iron and vitamin D. Frequent small meals are recommended for young kids.
3) Factors that influence eating habits like food preferences are formed early and parents are strong influences. Food jags and picky eating are common and temporary.
This document discusses maintaining healthy weight in children with autism spectrum disorder (ASD) who have feeding difficulties or selective eating behaviors. It provides strategies for occupational therapists to address this issue. The document describes how mealtime is an important occupation that can be challenging for children with ASD due to sensory processing issues, behavioral rigidity, and medical factors. It emphasizes taking a family-centered approach and using sensory-based interventions, positive reinforcement, structured routines, and play to expand children's acceptance of foods. The document also notes higher rates of obesity in underserved populations and children with special needs.
The document discusses children with special health care needs. It defines these children as those who require health services beyond what is typical due to chronic conditions, disabilities, or developmental issues. These children face greater medical and financial burdens. The document advocates for a "medical home" approach that provides comprehensive, coordinated care centered around the needs of the child and family. It also explores the impact of illness on children and families, and the important role of family physicians in supporting these patients.
1) The document discusses feeding problems in children with special needs, including cerebral palsy, autism, cleft lip and palate, and ADHD.
2) Children with special needs may experience difficulties chewing, swallowing, and eating due to issues like spasticity, hyperactive gag reflex, and sensory processing problems.
3) Their nutritional needs may also not be met due to narrow food selections, mealtime tantrums, picky eating behaviors, and higher rates of gastrointestinal disorders. Maintaining proper nutrition is important for their development.
Maternal and child health interventions in ghanauhashohoe
Maternal and child health interventions are important in Ghana given high rates of maternal and child mortality. Key issues include malnutrition, infection, and uncontrolled fertility due to poverty. Interventions focus on antenatal care, immunizations, family planning, and addressing root causes like hygiene, nutrition, and socioeconomic factors. Antenatal services include physical exams, prenatal advice, testing and treatment for conditions like anemia, malaria and STIs. The overall goal is promoting long-term health for mothers and children.
This document discusses failure to thrive and short stature in children. It defines failure to thrive as inadequate calorie intake to support a child's growth and metabolic demands, resulting in growth failure. Causes of failure to thrive include inadequate nutrition from medical issues, psychosocial factors, or increased calorie expenditure from illness or disease. The assessment and management of failure to thrive involves detailed history, examinations to identify underlying causes, nutritional rehabilitation, parental counselling, and medical treatment. Short stature is defined as height below the 3rd percentile or 2 standard deviations below the mean for age and sex. The document discusses normal growth velocity and the determinants of child growth.
The document discusses health, illness, and disease across the lifespan from childhood to older adulthood. Key points include:
- Children's health is influenced by timely immunizations, accidents being a leading cause of death, and caregivers playing an important role. Poor health is also an issue for children in low-income families.
- Adolescence is a critical time for adopting health behaviors, with social contexts like families and peers being influential. Emerging adults have higher mortality rates than adolescents and may not consider how behaviors affect later health.
- Chronic illnesses become more common with age, with cancer and cardiovascular disease being leading causes of death. Alzheimer's and Parkinson's diseases are also discussed as forms of dementia that
Failure to thrive, or FTT, refers to inadequate growth and development in infants and children. A thorough evaluation of the child is needed to determine if FTT has an organic medical cause or is due to non-organic psychosocial factors. Laboratory investigations and nutritional management are important for diagnosis and treatment. The prognosis depends on the underlying cause, with organic causes having more variable outcomes depending on the specific condition, while psychosocial FTT can be associated with lasting developmental delays if not properly addressed.
Malnutrition is a major problem in India with multiple causes and serious consequences. It affects people of all ages but particularly impacts children under 5. Common causes of malnutrition in India include lack of food due to poverty, lack of nutrition education, and illnesses that decrease appetite or ability to absorb nutrients. Malnutrition can cause weight loss, fatigue, reduced growth in children, and increased risk of illness and death. Prevention strategies focus on breastfeeding, nutritional supplements, food fortification, and increasing access to nutritious foods.
This is an undergraduate presentation on failure to thrive in Pediatrics. In this presentation I mentioned about Diagnosis, Etiology, Etiology, Diagnostic Evaluation and Management.
https://orcid.org/0000-0001-9306-2267
https://1drv.ms/p/s!Am9GQ5GMX-WyjmOfgcNpov4RewVL
Pamudith Karunaratne
Failure to thrive malnutrition paedia . pptxAasthaPawar4
Failure to thrive is a disorder where infants and children do not gain weight or may lose weight at an expected rate. It is defined as weight being below the 3rd percentile on a growth chart or weight gain less than 20g/day from birth to 3 months or 15g/day from 3-6 months. Failure to thrive can be organic due to medical causes, inorganic due to non-medical causes like poor parenting, or mixed. Causes include inadequate calorie intake, absorption issues, increased calorie needs, excessive calorie loss, or altered growth regulation. Assessment involves a physical exam, growth chart, and lab tests. Management focuses on correcting underlying issues, improving nutrition and caregiving, and follow up to support catch
Failure to thrive is defined as sustained weight loss or failure to gain weight resulting in a child's weight falling below normal growth curves. It can be caused by inadequate nutrition intake, increased calorie needs, or issues with absorption. Evaluation involves assessing growth charts, nutrition intake, physical exam for signs of organic disease, and laboratory tests if indicated. Management goals are nutritional rehabilitation, treating any underlying medical causes, and addressing psychosocial factors. The prognosis depends on the etiology, with psychosocial causes having risks of developmental delays and organic causes having variable outcomes based on the specific condition.
The document discusses nutrition in preschool children ages 1-6. Key points include:
- Growth rates decrease in preschoolers, leading to less appetite and intake.
- Common nutritional problems are protein-energy malnutrition, iron-deficiency anemia, vitamin A deficiency, and iodine deficiency.
- Nutrient needs include adequate energy, protein, vitamins, minerals, and micronutrients for growth and development.
- Factors like family environment, media, illness can influence children's food intake. Feeding problems may occur and require intervention.
Constipation is a common gastrointestinal issue in children. It can be functional or organic in nature, with functional constipation making up the majority of cases. The document discusses the definition, epidemiology, risk factors, evaluation, and management of pediatric constipation. Evaluation involves history, physical exam, and potential imaging and testing. Management is multi-pronged, focusing on education, dietary changes, behavioral modifications, disimpaction if needed, and long-term maintenance therapy often involving laxatives. Surgery is rarely needed and reserved for severe, refractory cases. Childhood constipation can sometimes predict irritable bowel syndrome in adulthood.
This document outlines a lecture on child and preadolescent nutrition. It discusses normal growth and development in children, including adiposity rebound. It also covers energy and nutrient needs, common nutrition problems like iron deficiency and dental caries, and childhood obesity including predictors, assessment, and treatment approaches. The goal of obesity treatment is weight maintenance or gradual weight loss until a healthy BMI is achieved.
INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES.pptxgrace471714
This document discusses integrated management of childhood illnesses (IMCI), an approach developed by WHO and UNICEF to reduce child morbidity and mortality in developing countries. It focuses on improving health worker case management skills, strengthening health systems, and promoting family/community practices. The main causes of death in children under 5 are pneumonia, diarrhea, malaria, measles, and malnutrition. IMCI aims to classify and treat these illnesses early through integrated care. It uses charts to guide health workers through assessment, classification, treatment, counseling and follow-up. IMCI also promotes preventive measures, growth monitoring, and encourages communities to seek timely care.
Determinants of Eating Behavior and its Impact on Chronic Diseases.pptxWajid Rather
S-1 Prevalence of Chronic disease in India
S-2 Percentage of Hypertension in Indians
S-3 Percentage of Hypertension in Indians
S-4 Percentage of overweight Indians
S-6 Chronic diseases share
common risk factors and conditions
S-7 Major Factors Influence Our Eating Behavior
S-8 Portion sizes
S-9 Informational Eating Norms
S-10 Family and Social Determinants
S-11 Environmental Influences on eating Behaviour
S-12 Parental Influences on on children's Eating pattern and Food Choices
S-13 Eating Disorders
S-14 Types of Eating Disorders
S-15 Health Effects of Different Types of Eating Disorders
S-16-18 Diagnostic Consideration for Different types of Eating Disorders
S-23 Different Treatment Options for eating Disorders
S-24-27 Nutritional Assessment, Intervention and Nutrition Monitoring and Evaluation
Determinants of Eating Behavior and its impact on chronic Diseases.pdfWajid Rather
Slide no 1: Determinants of Eating Behavior and its Impact on Chronic Diseases
Slide -2 Prevalence of Chronic Diseases in India
Slide-3 Percentage of Hypertension in Indians
Slide-4 Percentage of Overweight Indians
Slide-5 Chronic Disease share common Risk factors and Conditions
Slide-6 Major Factors influence our Eating Behaviour and Food Choices
Slide-7 Portion Sizes
Slide-8 Information Eating Norms
Slide-9 Social Determinants
Slide-10 Environmental Influence on Children's Eating and Food Choices
Slide-11 Parental Influences on Children Eating and Food Choices
Slide-12 Eating Disorders
slide-13 Types of Eating Disorders
Slide-14 Health Effects of Different types of Eating Disorders
Slide -15 Diagnostic Consideration for different Eating Disorders
Slide-16 Treatment options for Eating Disorders
Slide -17 Nutrition Assessment
slide-18 Nutrition Intervention
Slide -19 Nutrition Monitoring and Evolution
1) The document discusses nutrition needs and eating behaviors for children from toddlerhood through adolescence.
2) Key nutrient needs include adequate calories, protein, calcium, iron and vitamin D. Frequent small meals are recommended for young kids.
3) Factors that influence eating habits like food preferences are formed early and parents are strong influences. Food jags and picky eating are common and temporary.
This document discusses maintaining healthy weight in children with autism spectrum disorder (ASD) who have feeding difficulties or selective eating behaviors. It provides strategies for occupational therapists to address this issue. The document describes how mealtime is an important occupation that can be challenging for children with ASD due to sensory processing issues, behavioral rigidity, and medical factors. It emphasizes taking a family-centered approach and using sensory-based interventions, positive reinforcement, structured routines, and play to expand children's acceptance of foods. The document also notes higher rates of obesity in underserved populations and children with special needs.
The document discusses children with special health care needs. It defines these children as those who require health services beyond what is typical due to chronic conditions, disabilities, or developmental issues. These children face greater medical and financial burdens. The document advocates for a "medical home" approach that provides comprehensive, coordinated care centered around the needs of the child and family. It also explores the impact of illness on children and families, and the important role of family physicians in supporting these patients.
1) The document discusses feeding problems in children with special needs, including cerebral palsy, autism, cleft lip and palate, and ADHD.
2) Children with special needs may experience difficulties chewing, swallowing, and eating due to issues like spasticity, hyperactive gag reflex, and sensory processing problems.
3) Their nutritional needs may also not be met due to narrow food selections, mealtime tantrums, picky eating behaviors, and higher rates of gastrointestinal disorders. Maintaining proper nutrition is important for their development.
Maternal and child health interventions in ghanauhashohoe
Maternal and child health interventions are important in Ghana given high rates of maternal and child mortality. Key issues include malnutrition, infection, and uncontrolled fertility due to poverty. Interventions focus on antenatal care, immunizations, family planning, and addressing root causes like hygiene, nutrition, and socioeconomic factors. Antenatal services include physical exams, prenatal advice, testing and treatment for conditions like anemia, malaria and STIs. The overall goal is promoting long-term health for mothers and children.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
FTT (1).pptx
1. FAILURE TO THRIVE
AND OTHER
PROBLEM WITH
NUTRITION
BY: DR NURLIDA ABD RAHIM
FMS UKM YEAR 1
TELECONFERENCE SESSION 15/10/2014
2. OUTLINE OF PRESENTATION
• DEFINITION AND CLASSIFICATION
• APPROACH TO FAILURE TO THRIVE
• HISTORY
• EXAMINATION
• INVESTIGATION
• MANAGEMENT
• REVIEW PAPER
• OTHER NUTRITIONAL PROBLEM
3. WHAT IS FAILURE TO THRIVE ?
• A significant interruption in the expected rate
of growth during early childhood
• weight less than the third to fifth percentile
for age on more than one occasion or
• weight measurements that fall 2 major
percentile lines using the standard growth
charts expected of similar children of the
same sex, age and ethnicity.
REF: National Center for Health Statistics (NCHS) www.cdc.gov/nchs
4. FAILURE TO THRIVE
• Prevalence 5 to 10% of children in primary care
settings
• Up to 80 % of children with FTT present before 18
months of age.
• REF: Schwartz ID. Failure to thrive: an old nemesis in the new millennium.
Pediatr Rev. 2000;21(8):257–264.
5. NORMAL VARIANT OF GROWTH
• children of small parents who are growing to their full
genetic potential,
• large-for-gestational-age infants who regress toward
the mean (postnatal catch-down)
• children with constitutional delay in growth, or
• premature infants whose growth parameters are
normal when corrected for gestational age.
REF: Bergman P, Graham J. An approach to “failure to thrive.” Aust Fam Physician.
2005;34(9):725–729.
7. REF: American Family Physician –Failure to Thrive: An update
http://www.aafp.org/afp/2011/0401/p829.html
8. COMMON PROBLEM IN PRIMARY CARE
• Inadequate caloric intake is the most common
etiology seen in primary care settings.
• In infants younger than eight weeks, problems
with feeding (e.g., poor sucking and
swallowing) and breastfeeding difficulties are
prominent.
• For older infants:-
• difficulty transitioning to solid foods
• insufficient breast milk or formula consumption
• excessive juice consumption and
• parental avoidance of high-calorie foods
often lead to FTT
• Family factors
9. APPROACH TO FAILURE TO THRIVE
• History: Prenatal & Perinatal
• Maternal age
• Gravidity & Parity
• Abortions / stillborn
• Pregnancy health history, including a detailed history of
weight gain, prenatal care, substance or cigarette use,
nutrition and unusual nutritional practices, general
complications, bleeding, Infections
• Labor and delivery and complications, if any
*Adapted from Medscape Article: Failure to Thrive by Andrew PS et. al. Jan 2013
10. HISTORY
• Neonatal medical history
• Gestational age determined at birth
• Intrauterine growth rate (IUGR)
• Apgar scores
• Birth weight, length, and head circumference with
percentiles
• Neonatal course and complications, including sepsis,
jaundice, feeding intolerance or feeding difficulties
• Detailed medical history of newborn period
• Completed review of newborn screens
*Adapted from Medscape Article: Failure to Thrive by Andrew PS et. al. Jan 2013
11. CHILD MEDICAL HISTORY
• Medical history
• Immunizations
• Medications and Allergies
• Food intolerance / Formula intolerance
• Weight loss
• Vomiting and/or Diarrhea
• Dysphagia
• Snoring / Sleep apnea
• Recurrent respiratory or other bacterial and viral infections
• Signs of immune deficiency
• Malabsorption symptoms and signs
• CNS abnormalities
• Growth and developmental progress(delay or regressed milestones)
*Adapted from Medscape Article: Failure to Thrive by Andrew PS et. al. Jan 2013
12. FEEDING AND NUTRITIONAL HISTORY
• Dietary details - Milk, formula, solids, vitamins, other
supplements, food allergy or intolerance
• Caregivers' knowledge - Nutrition and feeding,
dietary beliefs, religious and cultural beliefs about
food, any unusual diets that might be inappropriate
for a child, inadequate amounts or typres
• Basic food and nutritional needs - Anything that
prevents the family from getting food (eg, finances,
transportation, subsidized programs); appropriate
and safe preparation of food by the caregiver (eg,
clean water, housing or shelter, cooking facility,
refrigeration, cooking knowledge)
*Adapted from Medscape Article: Failure to Thrive by Andrew PS et. al. Jan 2013
13. FEEDING BEHAVIOUR
• Is there is any sucking, chewing or swallowing
difficulty?
• Frequency and timing of meals
• Limited food preference or negative responses to food
and feeding
• Observe breastfeeding to ensure proper technique,
latch-on and swallowing
• Quantification is easy with bottle-feeding; if
breastfeeding- for EBM and measure volume
• Food journal for three days for older children and
adolescents
• Eating habits inside and outside of the home (e.g., day
care, school)
• Eating habits of parents or siblings at the same age as
the patient.
14. PSYCHOSOCIAL HISTORY
(NON ORGANIC CAUSES)
• Finances & poverty risk factors
• Family structure and living condition
• Caregiver identity and responsibility, mental health issues including
risks for or signs of maternal postpartum depression
• Daycare use
• Beliefs about child rearing
• History of abuse or neglect
• Family substance abuse or addiction
• Violence or chaotic family structure
• Educational level of parent or caregiver
• Food subsidy (food basket, soup kitchen)
• Welfare (JKM allowance)
• Transportation problems
• Health insurance
• Family or cultural concepts on feeding and specific foods
*Adapted from Medscape Article: Failure to Thrive by Andrew PS et. al. Jan 2013
15. PHYSICAL EXAMINATION
• Detailed and careful physical examination to
detect any disease or syndrome that might affect
growth and development.
• Growth parameters (weight, length, head
circumference and BMI) should be plotted on the
appropriate growth chart.
• Multiple data points are helpful to evaluate trends
in growth. Weight should be measured with the
child unclothed.
• Some conditions, such as Down syndrome, Turner
syndrome require specific growth chart.
16. GENERAL EXAMINATION
• Vital signs - Temperature, blood pressure, pulse,
respiration, hydration status
• General - Appearance, activity, affect
• Face – Dysmorphism
• Child behaviours - Gaze avoidance, arching,
hypertonicity, refusal to attach or respond
appropriately, unusual body movements, fretfulness
• Skin and hair - Poor hair texture and amount, nails,
alopecia, hygiene, rashes, birth marks, trauma (eg,
bruises, burns, or scars as signs of physical abuse)
17. HEAD AND FACE
• Head - Size, frontal bossing, fontanelle size and
patency, dysmorphism
• Eyes - Dysmorphia, ptosis, sunset sign, palpebral
fissures, pallor, trauma, optic discs
• External ears - Size, shape, position, infection
• Middle ears - Infection, acute or chronic
• Mouth and pharynx – Palate and /or cleft
deformity, tongue, teeth, caries, glossitis, mucous
membrane hydration or lesions, thrush, bleeding,
unusual odours to the breath
18. • Chest – Chest deformity, breath sound, cardiac
examination for murmurs or cardiomegaly or
arrhythmias
• Abdomen - Protuberance, organomegaly, masses,
bowel sounds, normal umbilicus healing in infant
• Genitalia - Normal for age, malformations,
ambiguous in quality, hygiene, trauma
• Extremities - Edema; digit malformations;
examination of the nails, joints, spine, and back
• Neurologic function - Cranial nerves, reflexes
(increased or decreased), tone, infant reflexes
present or extinguished at appropriate age, gait,
suck/swallow coordination
• Muscles - Muscle development and quality and
texture of muscle mass
19. INVESTIGATION
• Investigations should be guided by the history and
examination.
• Children who are generally well – with no positive
findings - may require no immediate investigation.
• Infants who are either unwell or have significant
positive physical findings will require immediate
investigation and consideration of paediatric
referral.
• In those requiring investigation, initial screening may
include:
• FBC, ESR, RP, Ca, Mg, PO4, UFEME/C&S
21. TREATMENT
• If FTT is caused by a specific medical condition –
then it should be treated accordingly. For example:
diuretics for heart failure, thyroid medication,
lactose free milk for lactose intolerance,
correctional operation for GI problem.
• Pediatric medical or surgical subspecialists should
be involved in the long-term treatment and
monitoring of organic illness if identified.
22. REF: American Family Physician –Failure to Thrive: An update
http://www.aafp.org/afp/2011/0401/p829.html
23. TREATMENT
• If a diagnosis of FTT is made and no medical conditions
are suggested on examination, appropriate guidance
for catch-up growth should be made.
• Most children require 100-120 kcal/kg/day, but this
may be increased to achieve catch-up weight gain
that is greater than normal.
• AHA estimated calories needed by children:
• 900kcal/day for a 1-year-old
• 1000kcal/day for 2-3 year old
• 1,800kcal/day for a 14–18-year-old girl
• 2,200kcal/day for a 14–18-year-old boy
• Increased physical activity will require additional
calories: by 0-200 kcal/d if moderately physically
active; and by 200–400 kcal/d if very physically active.
24. TREATMENT
• INTERDISPLINARY TEAM APPROACH- When treating
children with failure to thrive, an interdisciplinary team
approach combining pediatric, nutritional, mental
health, and social work is optimal.
• Home visits can help determine the underlying reason
for the nonorganic failure to thrive and can help
support the caregiver.
• Structured follow up plan after discharge.
• An older child with a chronic illness and failure to thrive
may benefit from referral to a psychologist.
• If neglect is suspected, child protection services should
become involved.
25. PRACTICAL DIETARY
RECOMMENDATION
• Eliminate empty calories from items such as soda or other
high sugar drinks.
• Schedule regular meals and snacks (usually 3 meals and 2
snacks per day). No grazing between meals.
• Offer solids before liquids.
• Increase protein and carbohydrates.
• Supplementation for older children may include adding
meat sauces, oil, cheese, sour cream, butter, margarine,
or peanut butter to meals.
• High-energy (approximately 1 kcal/mL) shakes, which are
available in different flavors (eg, Pedia Sure, Nutren
Junior).
• Multivitamin and mineral supplements, including iron and
zinc, are usually recommended to all undernourished
children.
26. DOES CHILD WITH FTT NEED IN-
PATIENT CARE?
• Most children with failure to thrive (FTT) can be treated
as outpatients. However, serial visits are mandatory, with
documentation of weight gain and/or daily caloric
intake.
• Who need in-patient care?
• Failure of outpatient management,
• Suspicion of abuse or neglect
• Severe psychosocial impairment of the caregiver
• Severe malnutrition as evidenced by cachexia or marasmus
27. LITERATURE REVIEW
(PEDIATRICS: 2007 JUL; 120(1):59-69)
• Early intervention and recovery among children
with failure to thrive: follow-up at age 8.
• Black MM, Dubowitz H, Krishnakumar A, Starr RH Jr.
• Department of Pediatrics, University of Maryland
School of Medicine, Baltimore, USA.
28. EARLY INTERVENTION AND RECOVERY AMONG
CHILDREN WITH FAILURE TO THRIVE:
FOLLOW-UP AT AGE 8
• Type of study: RCT
• Objectives: to examine the impact of home visiting
among infants with failure to thrive on growth,
academic/cognitive performance, and
home/classroom behavior at age 8.
• Method: Infants with failure to thrive (N = 130) or
adequate growth (N = 119) were recruited from
pediatric primary care clinics serving low-income,
urban communities.
• Eligibility criteria: included age <25 months,
gestational age >36 weeks, birth weight >2500 g,
and no significant medical conditions.
30. FOLLOW-UP AT AGE 8
• Follow-up visits were conducted by evaluators who
were unaware of the children's growth or
intervention history.
• At age 8, the evaluation included anthropometries,
the Wechsler Intelligence Scale for Children III, and
the Wide Range Achievement Test, Revised.
Mothers completed the Child Behavior Checklist
and teachers completed the Teacher Report Form.
31. RESULTS (RETENTION RATE :74% TO 78%)
• Analysis done by multivariate analyses of variance
• Children in the adequate-growth group were
significantly taller, heavier, and had better arithmetic
scores than the clinical-intervention-only group.
• Children in clinical-intervention-plus-home-intervention
group were also taller, heavier and had better
arithmetic scores than the clinical-intervention-only
group.
• There were no group differences in IQ, reading, or
mother-reported behavior problems.
• Children in the clinical-intervention-plus-home-
intervention group had fewer teacher-reported
internalizing problems and better work habits than the
clinical-intervention-only group.
32. CONCLUSION
• Early failure to thrive increased children's
vulnerability to short stature, poor arithmetic
performance, and poor work habits.
• Home visiting attenuated some of the negative
effects of early failure to thrive, possibly by
promoting maternal sensitivity and helping children
build strong work habits that enabled them to
benefit from school.
• Findings provide evidence for early intervention
programs for vulnerable infants.
34. BURDEN OF DISEASE
• Childhood malnutrition is the underlying cause of
death in an estimated 35% of all deaths among
children under the age of five years.
• REF: Comprehensive Implementation Plan on Maternal, Infant and Young
Child Nutrition WHO 2014
35. GLOBAL TARGET NO 6:
BY 2025, REDUCE AND
MAINTAIN CHILDHOOD
WASTING
TO LESS THAN 5%.
36. WASTING REDUCTION
• improved access to high-quality foods and to health
care;
• improved nutrition and health knowledge and
practices;
• promotion of exclusive breastfeeding for the first six
months and promotion of improved complementary
feeding practices for all children aged 6–24 months;
• and improved water and sanitation systems and
hygiene practices to protect children against
communicable diseases.
37. MALNUTRITION
• Causes:
• Inadequate or unbalanced diet
• Problems with digestion or absorption
• Certain medical conditions
• Starvation is a form of malnutrition.
• Malnutrition may also developed in form
micronutrient/macronutrient deficiency.
38. MARASMUS
This 6-month-old infant was admitted with marasmus. The infant was born
to a mother who did not bond effectively because of postpartum
depression. He has evidence of severe wasting and neglectful care as
also evidenced by the diaper excoriation. Weight gain was achieved by
placement in foster home.
Sirotnak Ap et. Al. Failure to thrive. Medscape Article. 2013 Jan.
39. PROTEIN ENERGY MALNUTRITION
MARASMUS KWASHIORKOR
• Obvious loss of weight with gross
reduction in muscle mass
especially from limb girdles.
Subcutaneous fat virtually
absent.
• Thin, atrophic skin lies in folds.
• Pinched face has appearance
of old man or monkey.
• Alopecia and brittle hair.
• Sometimes, appearance of
lanugo hair.
• Usually occurs in children aged
1-2 years with changing hair
colour to red, grey or blonde.
• Moon facies, swollen abdomen
(pot belly), hepatomegaly and
pitting oedema.
• Dry, dark skin which splits where
stretched over pressure areas to
reveal pale area.
42. OBESITY
• According to WHO, the number of overweight
children under the age of five was estimated in
2010 to be more than 42 million globally.
• Obesity is caused by imbalance between energy
input and expenditure.
• Dietary habit
• Lack of exercise, sedentary lifestyle
• Sleep deprivation
• Genetic contribution
• Socio-economic status
• Physical condition (such as endocrine causes)
43. By 2025, no increase in childhood
overweight.
The target implies that the global
prevalence of 6.7% estimated for
2010 should not rise to 10.8% (in 2025)
as per current trends and that the
number of overweight children
under five years should not increase
from 42 million
45. REFERENCES
1. Black MM, Dubowitz H, Krishnakumar A, Starr RH Jr. Early intervention and
recovery among children with failure to thrive: follow-up at age 8.
Pediatrics.2007 Jul;120(1):59-69. PubMed PMID: 17606562
2. Rabinowitz SS et. Al. Nutritional Consideration in Failure to Thrive Follow Up.
Medcape. 2014 Apr.
3. Sirotnak Ap et. Al. Failure to thrive. Medscape. 2013 Jan.
4. Cole SZ et. Al. Failure to thrive: an update. American Family
Physician. 2011 Apr 1;83(7):829-834
5. Bergman P, Graham J. An approach to “failure to thrive.” Aust Fam
Physician. 2005;34(9):725–729.
6. Rudolf MC, Logan S; What is the long term outcome for children who fail to
thrive? A systematic review. Arch Dis Child. 2005 Sep;90(9):925-31. Epub
2005 May 12
7. Shields B, Wacogne I, Wright CM; Weight faltering and failure to thrive in
infancy and early childhood. BMJ. 2012 Sep 25;345:e5931. doi:
10.1136/bmj.e5931.
8. Andrew PS et. al. Medscape Article: Failure to Thrive by Jan 2013
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