FAILURE TO THRIVE.

Failure to thrive is a commonly encountered problem in Paediatric practice. This essentially generic term refers to children whose attained weight or rate of weight gain is significantly below that of other children of similar age and same sex. Several defining criteria have been proposed and help to differentiate true failure to thrive from other conditions causing apparent growth failure. There are numerous organic causes of failure to thrive, but non-organic failure to thrive is also an important entity and is caused by social, psychological and environmental factors. The clinical features are those of malnutrition, signs of underlying organic cause and specific manifestations of environmental/psychosocial deprivation. Indiscriminate laboratory investigations are usually non-contributory and have no role in evaluation. Management requires a multidisciplinary approach and hospitalization has a specific role. Although nutritional rehabilitation is the cornerstone of therapy, treatment of underlying factors-medical, psychological, social and environmental-should receive equally important attention. Long term physical, developmental and behavioural sequelae are known to occur in children with failure to thrive.