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Failure to Thrive Differential Diagnoses

  • Author: Andrew P Sirotnak, MD; Chief Editor: Caroly Pataki, MD  more...
 
Updated: Nov 04, 2015
 
 

Diagnostic Considerations

Munchausen syndrome by proxy

Inborn error of metabolism and metabolic disease

Other endocrine disorder (thyroid disease, diabetes mellitus)

Genetic disorder

Malabsorption

Formula intolerance or allergy

Renal tubular acidosis

Congenital heart defect

Infants who are premature and who have had complications in the newborn period are at risk for growth failure. Premature infants who have intensive care needs at home are at greater risk for neglect or abuse.

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Andrew P Sirotnak, MD Professor and Vice Chair of Faculty Affairs, Department of Pediatrics, University of Colorado School of Medicine; Department Head, Child Abuse and Neglect, Director, Child Protection Team, The Children's Hospital

Andrew P Sirotnak, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Coauthor(s)

Antonia Chiesa, MD Assistant Professor of Pediatrics, University of Colorado School of Medicine

Antonia Chiesa, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References
  1. Cole SZ, Lanham JS. Failure to thrive: an update. Am Fam Physician. 2011 Apr 1. 83(7):829-34. [Medline].

  2. Black MM, Dubowitz H, Casey PH, et al. Failure to thrive as distinct from child neglect. Pediatrics. 2006 Apr. 117(4):1456-8; author reply 1458-9. [Medline].

  3. Block RW, Krebs NF, American Academy of Pediatrics Committee on Child Abuse and Neglect, American Academy of Pediatrics Committee on Nutrition. Failure to thrive as a manifestation of child neglect. Pediatrics. 2005 Nov. 116(5):1234-7. [Medline].

  4. Brewster DR. Inpatient management of severe malnutrition: time for a change in protocol and practice. Ann Trop Paediatr. 2011. 31(2):97-107. [Medline].

  5. Wojcicki JM, Holbrook K, Lustig RH, Epel E, Caughey AB, Muñoz RF, et al. Chronic maternal depression is associated with reduced weight gain in latino infants from birth to 2 years of age. PLoS One. 2011 Feb 23. 6(2):e16737. [Medline]. [Full Text].

  6. Bambang S, Spencer NJ, Logan S, Gill L. Cause-specific perinatal death rates, birth weight and deprivation in the West Midlands, 1991-93. Child Care Health Dev. 2000 Jan. 26(1):73-82. [Medline].

  7. Frank D, et al. Failure To Thrive. Reece R, Christian C, eds. Child Abuse Medical Diagnosis and Management. 3rd ed. Chicago, Ill: American Academy of Pediatrics; 2009. 465-512.

  8. Gahagan S. Failure to thrive: a consequence of undernutrition. Pediatr Rev. 2006 Jan. 27(1):e1-11. [Medline].

  9. Lowen D. Failure to Thrive. Jenny C, ed. Child Abuse and Neglect Diagnosis, Treatment and Evidence. 1st ed. St. Louis, Mo: Elsevier Saunders; 2011. 547-62.

 
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This 6-month-old infant was admitted with marasmus. The infant was born to a mother who did not bond effectively because of postpartum depression. He has evidence of severe wasting and neglectful care as also evidenced by the diaper excoriation. Weight gain was achieved by placement in foster home.
 
 
 
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