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Failure to thrive during infancy in siblings of pediatric cancer patients

From 1971 through 1980, 65 infants were born into 395 families who had a child diagnosed with cancer. Of these 65 infants, four born at or above the 50th percentile for weight (on standardized charts) have failed to thrive, with a decrease in weight below the fifth percentile at some time during the first 18 months. One was born 1 month prior to her brother's death, one was born at a time when the patient was doing poorly 6 months prior to death, one was born 18 months after his sister's death and was expected to be a “replacement” child. The fourth infant was born 21/2 years after the diagnosis of leukemia in the firstborn son. The mother's anxiety increased in the 6-month period prior to the anticipated termination of chemotherapy. The infant's weight dropped dramatically during this period and fell off the curve at about the same time that a testicular relapse was discovered. Five additional babies had weight below the tenth percentile at some time during the first 18 months of life. For all nine babies, periods of inadequate weight gain were associated with significant events or anniversaries of events (e.g. diagnosis, death, relapse) in the course of the patient's illness. These events and their anniversaries are times of sadness and tension for the families of children with cancer. Failure to thrive in infants born into these families is seen as a reflection of the parents' inability to care for and feed their newborn infants because of the stresses associated with cancer in another child in the family.