Failure To Thrive: The Medical Evaluation (From The New Child Protection Team Handbook, P 82-101, 1988, Donald C Bross, eds. -- See NCJ-115142)

• NCJ Number: 115145
• Author(s): B D Schmitt
• Date Published: 1988
• Length: 20 pages
• Sale Source: Garland Publishing, Inc.
• Publication Type: Training (Aid/Material)
• Language: English
• Country: United States of America

Annotation

After defining a child's failure to thrive (FTT), this paper addresses types of FTT, frequency and age distribution, the evaluation of FTT, guidelines for hospitalization, outpatient and inpatient management of FTT, diagnostic criteria for neglectful FTT, reporting guidelines for placement in a foster home, and a treatment plan for infants discharged to their natural home.

Abstract

The current best operational definition of FTT is an actual weight that is 20 percent or more below the ideal weight for an infant's height. Some imitators of FTT are short stature, normal shifting linear growth, and normal leanness. Types of FTT are nonorganic (70 percent of cases) and organic. This paper reviews the frequency of FTT at four hospitals throughout the Nation. Most infants with FTT are under 1 year of age. The evaluation of FTT involves a feeding history, previous health care, a growth chart, a physical examination, laboratory studies, observation of the infant's feeding performance, developmental evaluation, observations of mother-child interactions, psychosocial evaluation of the mother, and a radiologic bone survey. Guidelines for hospitalization pertain to the quality of the mother-child interaction, the child's development, and the severity of deprivation of abuse. The main thrust of outpatient management is a new feeding program, new support systems for the mother, and a method of monitoring progress. Inpatient management of FTT requires a feeding program, stimulation program, and parent counseling. Diagnosis of underfeeding requires subsequent documentation of a rapid weight gain and the improvement of any deprivational behaviors. By law (in New York), all cases of FTT due to underfeeding or maternal neglect must be reported to the child protective services agency in the patient's county of residence. The paper concludes with a listing of guidelines for placement in a foster home and the aspects of a treatment plan for infants discharged to their natural home. 26 references.