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Failure to Thrive - Criteria for Diagnosis

Failure to thrive is a condition in which nutrition is insufficient to maintain adequate growth. It can result from many factors, such as inadequate intake, increased metabolic demand, decreased nutrient absorption, and increased nutrient losses. Sometimes multiple factors play a role. There are many different anthropometric criteria for the diagnosis, some of the more common will be described below.

Common Anthropometric Criteria

Failure to thrive should be considered when a child is less than the 5th percentile among children of the same sex and corrected age for: weight, weight velocity, weight for length, length, or BMI. The diagnosis of failure to thrive may still be considered for children above the 5th percentile for the aforementioned growth parameters if their weight is less than 75% of median weight for age or length; or if two major percentiles lines have been crossed in regard to weight for age or weight for length. Now, keep in mind that a portion of healthy infants also cross 2 major percentile lines on the weight-for-age growth chart. Nonetheless, careful consideration of an underlying cause is warranted whenever one of these criteria are met. Other criteria, such as average daily weight gain may also be taken into consideration. And I would also like to note that in premature infants, corrections for gestational age should be made for weight until 2 years of age.

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