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
- Weight crosses 2 major percentage lines in a downward
- 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
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, &
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.