FAILURE TO THRIVE

What is it?

If your child 'fails to thrive' it means he or she is not growing at the rate doctors would expect compared to other children of the same age.

All children's growth is measured along charts which show how fast the average child's weight, height and head measurements increase as they grow. If a child is on the 50th 'centile line', it means 50 per cent of children of that age and sex are bigger than him or her and 50 per cent are smaller. If he or she is on the 0.5th centile, it means only 0.5 per cent of children are smaller than him or her and 99.5 per cent are bigger. A child is defined as failing to thrive if his or her weight drops rapidly away from these centile lines, or if his or her weight is below the 0.5th centile.

What causes it?

Some children are naturally small - perhaps if their parents are small. But failure to thrive can be caused by not eating enough of the right foods, by not absorbing food properly, because the child has another long-term illness or because of problems in the home.

Who gets it?

Children often go through phases of being 'fussy eaters', but this rarely does them any long-term harm - their weight will usually pick up once their diet improves. However, if feeding time becomes a battle of wills, your child may pick up on your frustration and refuse to feed properly.

Your child may fail to thrive if he or she has a bowel problem, such as coeliac disease, which stops foods being absorbed.

The child's weight may drop off if he or she has persistent diarrhoea or vomiting, or if there is a long-standing problem with another part of his or her body, such as liver or kidney disease, severe asthma or repeated urine infections.

What are the symptoms?

You may notice your child is smaller than other children of his or her age, lacking in energy or that his or her development is delayed. Failure to thrive may be picked up when you take your child for a routine check-up with your health visitor or GP, and his or her weight is found to have dropped or not increased as much as it should. The child may have persistent vomiting or diarrhoea, or produce a lot of foul-smelling stools.

When should I go to my doctor?

If you think your child is underweight, go to your health visitor's next clinic armed with your child's growth records and get him or her weighed. If your child is underweight, your health visitor will arrange for him or her to see your GP.

What tests will my doctor do?

Your GP will want to check how fast your child has been growing, ask questions and examine him or her. Your GP may be able to reassure you and ask you to come back soon for another weight check. If your child's weight gain is abnormally low, your GP will either organise some blood tests or refer the child to a hospital specialist.

What is the short-term treatment?

This depends on whether there is an underlying problem, and if so, what it is. For example, your child may need tests to check if he or she is absorbing food properly. If he or she is found to be allergic to certain foods, you will have to cut these out of his or her diet.

Is long-term treatment needed?

Again, this depends on the cause. Your child's weight and development may have to be measured more often than usual for some time.