If your child isn’t growing as expected, you may be wondering if “failure to thrive” could be the cause.

“Failure to thrive” is a medical term describing a child whose weight or rate of weight gain falls below expected standards for their age and sex. Growth challenges can happen for many different reasons, most commonly when children don’t consume enough calories.

A primary care provider or pediatric specialist can help identify and treat the underlying cause, so your child’s growth can get back on track. Below, learn more about failure to thrive, and how your child’s care team can help address eating and growth concerns.

What Is Failure To Thrive?

“Failure to thrive” is a term used to describe inadequate weight gain or growth (specifically, height and weight measurements that fall below the 3rd and 5th percentile, or a downward trend in growth across growth percentiles).

Because “failure to thrive” has a negative connotation, many providers are moving away from using the term. Instead, many describe the symptom of “inadequate growth.”

This can happen for many reasons, including medical, behavioral and social causes, which often overlap. One common cause in babies is difficulty feeding. Potential medical conditions that can affect a child’s growth include:

• Chromosomal abnormalities, such as Down syndrome
  
  
• Endocrine conditions, such as thyroid deficiency or growth hormone deficiency
  
  
• Blood disorders, such as anemia
  
  
• Severe allergies 
  
  
• Gastrointestinal disorders, such as Celiac disease 
  
  
• Metabolic disorders, such as such as phenylketonuria (PKU) and other rare conditions that affect how the body processes nutrients and produces energy
  
  
• Gastroesophageal reflux

Symptoms of Failure To Thrive

Every child is different, and symptoms may vary depending on factors like the underlying cause and degree of nutritional deficiency.

Age can also impact symptoms. For example, a baby may struggle to transition from a bottle to solids, a toddler may wake up to feed multiple times a night and an older child may graze on snacks throughout the day.

These signs and symptoms may occur with inadequate calories:

• Lack of appropriate weight gain and overall growth
  
  
• Irritability 
  
  
• Fatigue and sleepiness
  
  
• Slower-than-expected development
  
  
• Learning and behavioral differences

Keep in mind that some children may have several symptoms, while others may not display any except lack of expected growth.

When To See a Doctor

Your child’s primary care provider will closely monitor their growth and eating habits at well-child visits.

If you’re concerned about your child’s eating habits, nutritional intake or growth, it’s never too soon to check in with an expert. Your child’s pediatrician can recommend ways to improve calorie intake to support your child’s growth, such as high-calorie nutritional supplements.

If needed, your child’s pediatrician can refer you to a specialist to determine and address the underlying cause of inadequate growth. In the case of an underlying medical condition, treating it often helps. Specialists can also help families find practical ways to increase calorie intake and nutrition.

It can be discouraging and even scary when your child’s growth or eating habits aren’t as expected. The right support can help your child back on track.