Fortnightly Reviews: Failure to thrive

“Failure to thrive” is a descriptive term, not a diagnosis. There is no clear agreement on definition; one commonly used is, “when his or her rate of growth fails to meet the potential expected for a child of that age.” 1 As it is difficult to predict potential, such a definition might initially include many normal children of short stature. Illingworth added to the definition evidence of lassitude, loss of energy and joie de vivre.2

A major paediatric textbook includes “signs of developmental retardation and of physical and emotional deprivation such as apathy, poor hygiene, intense eye contact with people and withdrawing behaviour as well as disorders of oral intake which may be manifested as anorexia, voracious appetite or pica.” 3 This description attempts to combine some of the characteristics of psychosocial deprivation with those of eating disorder and poor growth. Any combination may be present in an individual child.