What does failure to thrive mean?

Failure to thrive is a medical term for slower-than-expected growth or inadequate weight gain in a child. It is also described as faltering growth. The term is a sign that a child’s growth pattern needs assessment, not a diagnosis of one particular illness. A clinician considers the child’s age, growth over time, feeding, development, health and family pattern together.

Children grow at different rates, and one measurement does not explain the whole picture. Clinicians may review weight, length or height, head growth where relevant, and the direction of those measurements on a growth chart. They may ask whether feeding is difficult, whether the child keeps food down, and whether bowel symptoms, breathing problems or repeated infections are present. Growth can be affected by feeding challenges, difficulty absorbing nutrients, ongoing medical conditions, emotional or social pressures, or a combination of factors. A careful history and examination help identify which possibilities need attention.

Arrange a child health assessment if a clinician has raised concern about growth, or if you notice a persistent change in eating, drinking or weight. Bring the child’s health records and a short account of usual meals, drinks, snacks, vomiting, stools and activity. Do not pressure a child to eat or start supplements without professional advice. The clinician may observe a feed, review the growth chart, examine the child and decide whether tests or support from a dietitian or another specialist would help.

Seek urgent medical advice if a child is unusually sleepy, difficult to wake, struggling to breathe, unable to keep fluids down, or passing much less urine than usual. Get prompt help for signs of dehydration such as a very dry mouth, no tears when crying, or markedly reduced alertness. Contact a clinician soon if feeding has become consistently difficult, weight appears to be falling, vomiting or diarrhoea continues, or the child is not meeting expected developmental skills. An emergency service is appropriate when the child appears seriously unwell.

You could ask: Which growth measurements are causing concern? How has the pattern changed over time? Could feeding technique, swallowing, digestion or another health issue be contributing? What should I record at home? Are there foods, drinks or supplements to use or avoid? When should growth be reviewed again, and which symptoms should prompt earlier contact?