Failure to Thrive: To Recognize, to Diagnose and to Treat

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Failure to Thrive: To Recognize, to Diagnose and to Treat

Pietrobelli, Angelo; (2021) Failure to Thrive: To Recognize, to Diagnose and to Treat. Food Science and Nutrition , 7 (3) , Article 105. 10.24966/fsn-1076/100105. Green open access

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Abstract

Failure to Thrive (FTT) is a condition of abnormal growth pattern due to a state of malnutrition, that may impair child’s future growth. According with the American Society for Parenteral and Enteral Nutrition (ASPEN), malnutrition, either in excess or in defect, is an imbalance between caloric intake and energy expenditure. Providing an accurate diagnosis and assuring an effective management of this condition appears essential to the clinician. An appropriate treatment is also fundamental to achieve standard growth and to avoid FTT long term effects. However, a common approach to treat, and practical management cannot clearly be recognized in literature yet. Therefore, the purpose of our narrative review is to find reliable and unambiguous indications for optimizing diagnosis, assessment and management of failure to thrive in infants under two years. We will focus on anthropometric tools for diagnosis of FTT, role of anamnesis and physical examination, timing for blood and instrumental exams and first line treatment, to finalize with a common protocol/flow-chart. Comprehensive electronic literature searches were performed to find all relevant literature reporting diagnostic criteria for FTT. 11 selected papers were then analysed and a flow chart was finally proposed to synthetize the findings and suggesting the clinical approach to FTT. We found no commonly accepted definition nor a definite pathway to identify FTT in infancy, diagnose it, manage it and follow it up is present in literature. Main limitations of this work are 1: The lack of cohort studies for faltering growth to have reliable indicators; 2: The lack of a proper validation of the proposed flow chart. It would be of extreme interest to start a prospective study, applying the proposed flow chart to assess if efficacious in identifying and successfully managing a child presenting with abnormal growth pattern.

Type:	Article
Title:	Failure to Thrive: To Recognize, to Diagnose and to Treat
Open access status:	An open access version is available from UCL Discovery
DOI:	10.24966/fsn-1076/100105
Publisher version:	http://dx.doi.org/10.24966/fsn-1076/100105
Language:	English
Additional information:	© 2021 Messina M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Keywords:	Caloric intake; Children; Energy expenditure; Growth; Malnutrition; Nutrition
UCL classification:	UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Genetics and Genomic Medicine Dept
URI:	https://discovery.ucl.ac.uk/id/eprint/10189465