Infant Growth: Is Your Child on Track?

Have you heard of the medical term "failure to thrive?" You may have heard your child's pediatrician mention this concern if your child has fallen two or more percentiles on his or her growth chart over a fairly brief time span. This becomes a serious issue when your child stays on the very bottom percentile or grows inadequately over time. Faced with one of those three situations, your child's healthcare provider will need to investigate the reasons for your little one experiencing a "failure to thrive." (Note: "Failure to thrive" is not a diagnosis. It’s a description and the causes are many and represent a wide variety of conditions both medical and psychosocial.)

Here's a look at two examples and how doctors discover failure-to-thrive cases:

CASE 1: Martin brings his seven-month-old daughter, Jade, to the doctor because she has a runny nose and a slight cough. The doctor's impression is that Jade has a minor cold, but she notes that the baby also looks thin. She plots the baby's length and weight on a standard growth chart and tells Martin that his daughter has fallen from the middle of both charts at birth to the bottom percentile today.

The pediatrician explains that the possible reasons for this poor growth are many, and begins asking an extensive list of questions. She suggests that Jade undergo lab tests. Martin, whose original concern was his daughter's runny nose, is now worried and confused.

CASE 2: Jennifer brings her 12-month-old son, Patrick, to his pediatrician with the concern that he is not growing as well as he should. Compared to the way he ate at four months, she explains, Patrick is much less interested in food. He crawls constantly and Jennifer feels that he isn't eating more to make up for the calories he uses moving around. She asks for tests to see if anything serious is wrong.

After asking some questions and examining Patrick, the pediatrician shows Jennifer his growth chart. He is tracking nicely along the 25 percentile for length and weight, and Jennifer is told not to be concerned. The doctor is concerned, however, about Patrick's long-standing eczema and writes some new prescriptions for his skin. Jennifer, who leaves with a prescription she didn't anticipate and no lab testing, is also confused.