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Cindy W. Christian and Nathan J. Blum 5
Failure to thrive (FTT) is a descriptive term given to malnourished infants and young children who fail to meet expected standards of growth. FTT is most often used to describe malnutrition related to environmental or psychosocial causes. In many children with inadequate growth, however, organic and environmental contributors coexist, underscoring the importance of assessing potential medical, nutritional, developmental, psychosocial, and environmental contributors in all cases.
FTT is often diagnosed by weight that falls or remains below the 3rd percentile for age; decreases, crossing two major percentile lines on the growth chart over time; or is less than 80% of the median weight for the height of the child. Caveats to these definitions exist. According to growth chart standards, 3% of the population naturally falls below the 3rd percentile. These children, who typically have short stature or constitutional delay of growth, usually are proportional (normal weight for height). Additionally in the first few years of life, large fluctuations in percentile position can occur in normal children. Changes in weight should be assessed in relation to height (length) and head circumference.