Failure to thrive (FTT) prevalence varies depending on diagnostic criteria used. Various diagnostic criteria include:

  • Weight is <3% (or <5%) on the growth curve on more than one occasion
  • Weight crosses 2 major percentage lines in a downward direction
  • Weight less than 80% ideal body weight (IBW)
  • Weight to length curve is <3% (or <5%)
  • Lack of appropriate height growth or weight gain that cannot be attributed to another medical disorder

Studies in the early 1980's identified FTT children accounting for 1-5% of all hospital admissions (Berwick, Levy, & Kleinerman, 1982; Sills, 1978). Other estimates report up to 10% of children can be categorized with FTT (Gahagan & Holmes, 1998). Prevalence is considered higher in premature infants and children living in low socioeconomic status (Berwick, et al., 1982).

Classification of FTT has traditionally been categorized into underlying organic disease, nonorganic (psychosocial) or mixed etiology.

Refeeding syndrome (RFS) is a life threatening metabolic and biochemical dysfunction occurring as a consequence of reintroduction of feeds after a period of starvation. Electrolyte disturbances occur when the body's energy source is switched from fats and protein during starvation to glucose and subsequently insulin utilization when reefed. Incidence is unknown in both the adult and pediatric population (Boateng, Sriram, Meguid, & Crook, 2010). 

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.

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