The document discusses the management of failure to thrive (FTT) in children, emphasizing the importance of nutritional therapy to improve dietary intake for catch-up growth. It outlines individualized management plans that address medical, nutritional, developmental, and psychosocial factors, recommending high energy and nutrient-rich diets along with multivitamin supplementation. Additionally, it highlights the need for medical, developmental, and psychosocial interventions to support overall treatment effectiveness.

1. Managment of Failure
To Thrive
Abdullatiff Sami Al-Rashed
Block 3.4
College of Medicine, KFU
Al-Ahsa, Saudi Arabia

2. How do you treat a case of
failure to thrive with special
reference to nutritional
management?
How do you treat a case of
failure to thrive with special
reference to nutritional
management?

3. Introduction
• The term FTT is used to describe
instances of growth failure or,
more specifically, failure to gain
weight appropriately.
• A wide variety of medical
problems and psychosocial
stressors can contribute to FTT

4. Management
• The primary goal of management of
failure to thrive (FTT) is improved
nutritional status through provision of
adequate nutrient intake for catch-up
growth.
• Provision of adequate nutrient intake
may require changes to the diet, feeding
schedule, or feeding environment;
psychosocial stressors contributing to
undernutrition also must be addressed.

5. Management
• Management of children with FTT is
individualized according to the
needs of the child and family that
were identified during the evaluation
and the severity of the FTT.
• Successful management of FTT
requires a plan to address
contributing medical, nutritional,
developmental/behavioral, and
psychosocial factors.

6. Management

7. Management
• Nutritional therapy is the mainstay of
management.
• The goal of nutritional therapy is to enable
"catch-up" weight gain (ie, weight gain at a
rate that is two to three times greater than
average for age or approximately 45 to 60
g/day) so that the weight deficit is repaired
or overcome.
• The pace and aggressiveness of nutritional
repletion is determined by the degree of
malnutrition.

8. Nutritional Requirements
• Energy and protein — All children with
failure to thrive (FTT) require a diet high in
energy and other nutrients for catch-up
growth.
• Vitamins and minerals — During the
catch-up growth phase, existing stores of
vitamins and minerals may not be
sufficient. A multivitamin preparation that
includes iron and zinc for children who are
being treated for FTT is recommended

9. • Increasing intake — Strategies to achieve
adequate intake of energy and protein vary
depending upon the age and dietary
preferences of the child.
Nutritional Requirements

10. Infant Formula Preparation

11. OTHER INTERVENTIONS
• Medical — Medical management of
children with FTT entails intervention as
indicated for pathologic conditions
contributing to undernutrition.
• Developmental and
behavioral — Developmental and
behavioral problems may contribute to
inadequate intake (eg, oral motor
dysfunction) or increased losses (eg,
rumination).

12. OTHER INTERVENTIONS
• Psychosocial — The primary goal for
improved nutrition must be accompanied
by addressing the psychosocial
difficulties. Effective treatment, whether
inpatient or outpatient, requires
involvement and support of the
caretakers.

13. References