Do you ever have doubts or fears about your little one's growth? Maybe you feel like your baby isn't gaining weight properly, or maybe they're growing too slowly. This is actually a problem that many parents have. So today we're going to talk about this condition called "failure to thrive," or as it was called before. Now it's called "growth faltering."
What is this ``Growth Faltering''?
Simply put, growth faltering is when your child is not gaining weight or height in proportion to their age. The main cause of this is malnutrition, which means that the child is not getting enough nutrients, especially calories. This condition can occur in infants who are breastfed, as well as in older children, even children who are a few years old.
This used to be called ``Failure to Thrive''. Hearing those words can sometimes be a shock and a source of sadness. You may even think, "Did something go wrong with me?" But there are many things that can affect a child's growth, many of which we can't control. That's why doctors now use the term ``Growth Faltering'' instead of ``Failure to Thrive''. This refers to a problem with growth, not that you or your child is "failing." It is also sometimes called ``Weight Faltering'', which refers to weight loss.
Your pediatrician will determine the cause and start treatment for your child. You may need to make some changes to your child's diet. For example, if you are breastfeeding, you may need to give your child formula, or you may need to add nutritional supplements to your baby's formula, or you may need to add a high-calorie diet. Also, if there is an underlying medical condition that is affecting your child's growth, they will treat that as well.
What is the main reason for stunted growth?
Often, the main reason for a child's stunted growth is that the child is not getting the required amount of calories. Doctors also call this ``Inadequate caloric intake''. There can be many reasons why a child is not getting the required amount of calories. These reasons also vary depending on the child's age.
Reasons why breastfed babies may be getting fewer calories:
- Decreased milk supply in a nursing mother.
- The baby has latch difficulties, which means the baby is unable to suckle as much milk as needed.
- The formula given is not prepared correctly.
- The baby is not getting enough milk throughout the day.
Reasons why older children may be getting fewer calories:
- Eating disorders such as `(Avoidant/Restrictive Food Intake Disorder)`. Simply put, things like not liking or refusing to eat certain foods.
- Other eating disorders.
Another thing that affects children at all ages is food insecurity . That is, the difficulty in obtaining nutritious food. This situation can also cause a child to not get the calories they need and stunt their growth.
Are there other reasons for stunted growth?
Aside from not getting enough calories (this is the most common cause), there are several other reasons why children may have stunted growth:
- Inadequate nutrient absorption: This means that even though the child eats food, the nutrients in that food are not properly absorbed by the child's body. So the problem is not the amount of calories eaten, but how those calories are taken in and used for growth.
- Some of the conditions that affect this are:
- Celiac disease
- Conditions that affect the structure of the digestive system, such as biliary atresia, pyloric stenosis, and tracheoesophageal fistula
- Cystic fibrosis
- Inflammatory bowel disease
- Milk protein allergy
- Increased metabolic demand: This means that the child's body requires more calories than expected for normal functioning.
- Here are some examples of this:
- Cancer
- Congenital heart disease
- Congenital lung disorders
- HIV infection
- Hyperthyroidism
- Inborn errors of metabolism
- Kidney disease
- Tuberculosis
What are the symptoms of growth retardation?
Some of the symptoms you may notice in your child may include:
- Not gaining weight as expected.
- Not getting taller or not getting longer.
- Crying more than expected.
- Sleeping more than expected, sometimes even while breastfeeding.
- Not interacting with others in a way that is appropriate for the child's developmental stage (for example, not imitating your facial expressions).
You may not immediately realize that these are signs of developmental delay, but you may think, "Something is wrong." If you have any concerns about your child, especially if they are having difficulty waking up, see your pediatrician immediately.
Sometimes you may not notice any changes in your child. Doctors only detect this condition when they measure the child's weight and height in regular clinics.
What complications can occur if this condition is not treated?
If growth retardation in a baby is not treated, the following conditions may occur:
- Frequent infections.
- Brain development is affected and intellectual disability can occur.
- As we age, we can develop chronic diseases , such as cardiovascular disease and metabolic syndrome.
- As you get older, your height may be shorter than expected.
Research has shown that treating this growth retardation within the first two years of a child's life is very important to prevent future complications.
How do doctors diagnose growth retardation?
Doctors determine if a child has a growth delay by measuring their weight and height/length and comparing those values to standard growth charts. These growth charts show the expected growth rates for children at different ages. Some charts also adjust for special factors, such as preterm birth or children with certain genetic conditions.
If your child's development is slower than expected, your pediatrician will talk to you about possible causes. He or she will need to get some information from you to understand what factors are affecting your child's development. But remember, the doctor's goal is not to blame you or judge you, but to help your child and support your family. The more information you share, the more helpful the doctor can be.
Here are some things you can talk about (some may not be relevant depending on the child's age):
- How is breastfeeding going , and do you have any challenges?
- What type of formula do you use, and how do you make it?
- Has the baby started eating solid foods , and how is the baby responding to it?
- Any symptoms you notice when your child eats (e.g. coughing, vomiting, leaning back).
- The child's eating habits and preferences , including snacks and dislikes.
- How are meals served? Who is with the child while he eats?
- Your family's cultural practices regarding food.
- How is your family able to access nutritious food ?
Your pediatrician will review your child's medical records and ask about your family's medical history. This is because some diseases are "genetic," meaning you may have unknowingly affected your child early on. Making a list of diagnoses that you know your child's blood relatives have can help the doctor get the full picture.
Physical exam
Your pediatrician will perform a complete physical exam to assess your child's development and check for signs of medical conditions. This exam will provide information about your child's:
- Vital signs - such as pulse and blood pressure.
- Muscle mass and fat distribution.
- Hair health.
- Skin health status.
- Head circumference.
Testing
Doctors can often diagnose the cause of growth failure without any tests. However, to determine if there is an underlying medical condition, they may also order tests such as:
- Blood tests.
- Urine tests.
- Stool tests.
- Tests to diagnose specific medical conditions, for example, a sweat test for cystic fibrosis.
What are the treatments for this?
Treatment focuses on providing your child with enough nutrients to support their growth. Your pediatrician may recommend the following:
- If you have breastfeeding problems, seek the help of a lactation consultant.
- Giving formula in addition to breast milk. The doctor will explain what type of formula to give and how to give it.
- Creating a well-balanced meal plan that includes all the nutrients your child needs.
If your child has an underlying medical condition, your medical team will recommend appropriate treatment for that condition. This can vary greatly depending on the diagnosis. Your child's medical team will tell you more about what to expect.
Your pediatrician can refer you to other specialists - for example, a dietitian, social worker, or child psychologist - to support your family's needs. They can also help you find community-based programs that can help if you are not food secure or have other resources. If you have any concerns about your child's health, don't hesitate to tell your doctor.
Most children are treated with changes you make at home, with the support of your child's doctors (and regular follow-up visits). But some children may need to be hospitalized for growth failure. This allows doctors to monitor the child's calorie intake and determine the exact cause of the growth failure.
Hospitalization due to growth failure
Hospitalization of the child may be beneficial in the following cases:
- If home treatments do not help.
- If doctors need to accurately measure the types and amounts of nutrition a child is receiving.
- If the child has a serious underlying medical condition .
- If the child is severely malnourished or dehydrated .
- If you are having difficulty managing your child's condition at home.
- If the hospital is a safer place for the child due to certain circumstances at home.
If my baby has growth retardation, what should I expect?
You will need to go to regular follow-up clinics to monitor your child's development. This may be as often as once a week, but this will vary depending on the child's needs.
It can take four to nine months for a child to reach the desired growth rate. Your pediatrician will tell you when your child has reached an appropriate weight and height/length. Once that level is reached, the child is no longer stunted, and the child can then develop normally.
But not all children are the same. Some children may have relapses. This depends on the cause of the growth failure and whether the cause is adequately treated. Your pediatrician will monitor the situation closely and provide further treatment if necessary.
Can this situation be prevented?
Growth failure can't always be prevented. There are many reasons why your child may be growing more slowly than other children. But there are many things you can do to support your child's growth and development – even before they're born:
- Attend all clinics during your pregnancy and follow your doctor's instructions on how to take care of yourself during pregnancy.
- Be sure to take your child to all well visits.
- Learn about your baby's nutrition needs during their first year and beyond , and ask your doctor if you have any questions.
- If you notice any unusual symptoms in your child, or if you have any other concerns about your child's health, tell your doctor.
- If your family is having food security issues, let your doctor know. They often know of community-level resources that can help ensure that children get the food they need.
When should I see a doctor?
If you have any concerns about your child's growth or any other aspect of their development, see your pediatrician immediately. Growth failure doesn't always show obvious symptoms. That's why it's important to take your child to every regular clinic and let the doctor monitor your child's growth.
If your child has a growth delay, your doctor will tell you how often to come for follow-up clinics. These clinics are very important to check your child's development and adjust the treatment plan as needed.
You probably went to the doctor's office for a routine, daily check-up. But then you were told that your child has a developmental delay. Suddenly, a lot of questions probably came to your mind. "How did this happen? Is my child catching up with others? Did I do something wrong?"
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Don't worry. Most of the time, growth failure is caused by factors you can't control. Some children need a little extra help to grow at a rate appropriate for their age. And not every family has the same resources. Doctors know this, and they're ready to help.
Your pediatrician will work with you and your family to find out what you and your child need to support your child's development. It may take a few months, but your child will catch up and then develop as expected throughout childhood. If you need anything during this journey, don't hesitate to tell your doctor.
Finally, remember this.
So, you probably understand what `(Growth Faltering)` or stunted growth in a child is, its causes, symptoms and treatments. The most important thing is to understand that this is not your fault. Most of the time, these conditions occur for reasons beyond our control. If you don't panic, get the right medical advice, and do what the doctor says, you can give your little one the support he needs to grow healthy and well. Talk to the doctor about any questions or doubts you have. They are there to help you.
` Growth failure, failure to thrive, child nutrition, malnutrition, child growth, calories, child health
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