The physical exam is very important with these patients. Some studies site a rate of Failure to Thrive among the impoverished of as high as 10%. Inadequate access to food, parental depression or drug abuse, and serious parental discord can all affect the frequency of feedings. Common problems include overdilution of formula or inappropriate soft food consistency, excessive intake of water, infrequent feedings, lack of set feeding times, distractions at mealtime and regurgitation of food.Ī thorough psychosocial history can be very revealing as well. Included in this should be where, when, how and by whom the child is fed. The physician and the parents should work together to produce an accurate account of all meals, snacks, and drinks. The most common etiologies of Failure to Thrive lie in the dietary history and relate to inadequate nutritional intake. Important historical points which aid in diagnosis include a detailed dietary history, a detailed birth history including maternal infections and gestational age, and the age of onset of the failure to thrive if it is known. The most important initial step in the evaluation of Failure to Thrive includes a thorough history and physical examination. Thus, the etiology may be related to total parenteral intake, to the uptake and/or metabolism of that intake, or to structural abnormalities. One way to approach the evaluation of failure to thrive is to consider that the underlying issue is typically a variant of the same basis principle: inadequate usable nutrition. Typically, weight is affected before length, with head circumference being the last measurement affected. There is no concensus for the parameters of diagnosis, but common metrics for diagnosis include weight below the 2nd percentile on more than one occasion, or weight dropping more than 2 percentile groups. Failure to thrive is a clinical diagnosis which is often an indicator of difficulty with feeding but may also be sign of another underlying pathologic issue. It is characterized by inadequate weight gain when correcting for the child's gestational age, gender, and any relevant medical condition.
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