Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-23T04:03:11.014Z Has data issue: false hasContentIssue false

Failure to thrive in a population context: two contrasting studies of feeding and nutritional status

Published online by Cambridge University Press:  28 February 2007

Charlotte Wright*
Affiliation:
Community Child Health Unit, Donald Court House, 13 Walker Terrace, Gateshead NE8 1EB, UK
Jane Loughridge
Affiliation:
Community Child Health Unit, Donald Court House, 13 Walker Terrace, Gateshead NE8 1EB, UK
Gill Moore
Affiliation:
Community Child Health Unit, Donald Court House, 13 Walker Terrace, Gateshead NE8 1EB, UK
*
*Corresponding Author: Dr Charlotte Wright, fax +44 (0)191 4770370, email c.m.wright@ncl.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Although failure to thrive (FTT) is generally thought to be a nutritional problem, dietary intake in children with FTT has been little researched. We describe two community-based studies of dietary intake and eating behaviour in FTT. The first study of ninety-seven children with FTT identified by population screening found that only a minority of case children were associated with neglect, organic illness or deprivation, even though dietary information suggested an underlying nutritional cause in the majority. Limited case-control data suggested significantly delayed weaning and less liking for food in general among the case children. The second study found diminished appetite, delayed progression onto solid foods and fewer foods eaten by forty-four children referred with FTT compared with forty-five controls, but was unable to detect a significant difference in energy intake, even allowing for varying body composition and other confounding variables. This study also revealed the bias introduced by recruiting case children by referral rather than screening, and that despite rigorous matching procedures the controls were not representative of the general population. These studies suggest a wide range of differences in eating behaviour and feeding patterns between children with FTT and controls, but suggest that measurements of nutrient totals may not be robust. Studies of FTT based on referred children can be misleading, as can comparison with controls, unless allowance can be made for important confounding social variables.

Type
Reproduction and Development Group Symposium on ‘Feeding, nurture and childhood development’
Copyright
Copyright © The Nutrition Society 2000

References

Batchelor, J & Kerslake, A (1990) Failure to Find Failure to Thrive. London: Whiting and Bush.Google Scholar
Bithoney, WG, McJunkin, J, Mchalek, J, Egan, H, Synder, , & Munier, A (1989) Prospective evaluation of weight gain in both non-organic and organic failure to thrive children: an outpatient trial of a multidisciplinary team intervention strategy. Developmental and Behavioral Pediatrics 10, 2731.CrossRefGoogle Scholar
Black, MM, Dubowitz, H, Hutcheson, J, Berenson-Howard, J & Starr, RH (1995) A randomized clinical trial of home intervention for children with failure to thrive. Pediatrics 95, 807814.CrossRefGoogle ScholarPubMed
Department of Health (1994) Weaning and the Weaning Diet. Report on Health and Social Subjects no. 45. London: H.M. Stationery Office.Google Scholar
Dowdney, L, Skuse, D, Heptinstall, E, Puckering, C & Zur-Szpiro, S (1987) Growth retardation and developmental delay among inner-city children. Journal of Child Psychology and Psychiatry 28, 529541.CrossRefGoogle ScholarPubMed
Drotar, D, Malone, CA, Devost, L, Brickell, C, Mantz-Clumpner, C, Negray, J, Wallace, M, Woychick, J, Wyatt, B, Eckerle, D, Bush, M, Finlon, M, El-Amin, D, Nowak, M & Satola, J (1985) Early preventive intervention in failure to thrive: methods and preliminary outcome. In New Developments in Failure to Thrive, pp. 119138 [Drotar, D, editor]. New York: Plenum Press.CrossRefGoogle Scholar
Drotar, D & Sturm, L (1988) Prediction of intellectual development in young children with early histories of non-organic failure to thrive. Journal of Pediatric Psychology 13, 281296.CrossRefGoogle Scholar
Fletcher, L (1994) Microdiet.Salford: University of Salford.Google Scholar
Foster, K, Laider, D & Cheesbrough, S (1997) Infant Feeding 1995. London: H.M. Stationery Office.Google Scholar
Freeman, JV, Cole, TJ, Chinn, S, Jones, PRM, White, EM & Preece, MA (1995) Cross sectional stature and weight reference curves for the UK, 1990. Archives of Disease in Childhood 73, 1724.CrossRefGoogle ScholarPubMed
Garcia, SE, Kaiser, LL & Dewey, KG (1990) The relationship of eating frequency and caloric density to energy intake among rural Mexican pre-school children. European Journal of Clinical Nutrition 44, 381387.Google Scholar
Heptinstall, E, Puckering, C, Skuse, D, Start, K, Zur-Szpiro, S & Dowdney, L (1987) Nutrition and meal time behaviour in families of growth-retarded children. Human Nutrition: Applied Nutrition 41, 390402.Google Scholar
Nelson, M (1995) Editorial – can we measure what people eat? Journal of Human Nutrition and Dietetics 8, 12.CrossRefGoogle Scholar
Office of Population Censuses and Surveys (1992) 1991 Census. County Report: Tyne and Wear, part 1. London: H.M. Stationery Office.Google Scholar
Pollitt, E & Leibel, R (1980) Biological and social correlates of failure to thrive. In Social and Biological Predictors of Nutritional Status. Physical Growth and Neurological Development, pp. 173200 [Greene, LS and Johnston, FE, editors]. New York: Academic Press.Google Scholar
Skuse, D (1985) Non-organic failure to thrive: a reappraisal. Archives of Disease in Childhood 60, 173178.Google Scholar
Skuse, D, Gill, D, Reilly, S, Wolke, D & Lynch, M (1995) Failure to thrive and the risk of child abuse: a prospective population study. Journal of Medical Screening 2, 145149.CrossRefGoogle Scholar
Skuse, D, Reilly, S & Wolke, D (1994) Psychosocial adversity and growth during infancy. European Journal of Clinical Nutrition 47, Suppl. 1, 113130.Google Scholar
Skuse, D, Wolke, D & Reilly, S (1992) Failure to thrive: clinical and developmental aspects. In Developmental Psychopathology, pp. 4671 [Remschmidt, H and Schmidt, MH, editors]. Lewiston, NY: Hogrefe & Huber.Google Scholar
Wilensky, D, Ginsberg, G, Altman, M, Tulchinsky, T, Yishay, F & Auerbach, J (1996) A community based study of failure to thrive in Israel. Archives of Disease in Childhood 75, 145148.CrossRefGoogle ScholarPubMed
Wright, C, Avery, A, Epstein, M, Birks, E & Croft, D (1998a) New chart to evaluate weight faltering. Archives of Disease in Childhood 78, 4043.CrossRefGoogle ScholarPubMed
Wright, C & Birks, E (1999) Risk factors for failure to thrive: a population based survey. Child Care Health and Development (In the Press).Google Scholar
Wright, C, Callum, J, Birks, E & Jarvis, S (1998b) Community based management of failure to thrive: a randomised control trial. British Medical Journal 317, 571574.CrossRefGoogle Scholar
Wright, CM, Waterston, A, Matthews, JNS & Aynsley-Green, A (1994) What is the normal rate of weight gain in infancy? Acta Paediatrica 83, 351356.CrossRefGoogle ScholarPubMed