Failure to Thrive

Severe nonorganic failure to thrive is a potentially fatal illness. Nutritional deprivation can lead to death from starvation or overwhelming infection due to a weakened immune system. With detection and intervention, infants can in some cases recover from the effects of their condition. Brain size as measured by head circumference may be permanently reduced, especially if the failure to thrive occurred in the first six months of life. During this time of its most rapid growth, the brain is very susceptible to permanent damage from the effects of poor nutrition.

Later emotional and learning problems are common in these children. A 1988 Case Western Reserve University study found that the mean IQ score for three-year-old children with a prior history of failure to thrive was 85. A follow-up study of children from this group showed that even those who subsequently participated in early intervention programs had problems of personality development, deficient problem-solving skills, and more behavioral problems in general as compared to the controls. These problems included impulse control, gratification delay, and the ability to adapt behaviorally to new situations. An Israeli study found that at age five, about 11.5 percent of children with a history of failure to thrive had some manifestations of developmental delay, compared with no delays in the control children. They likewise found an 18 percent incidence of poor school performance compared with a 3.3 percent rate in the control group. Another follow-up study of children diagnosed with nonorganic failure to thrive found that at age six, half of the children in the study sample of twenty-one had abnormal personalities and two-thirds learned to read at a later-than-normal age. Two of the twenty-one had died under suspicious circumstances, pointing up the vulnerability of children with psychosocial failure to thrive. Another study determined that out of fifteen children initially diagnosed with growth failure caused by emotional deprivation, only two were functioning well three to eleven years after diagnosis. Infants hospitalized with failure to thrive prior to six months of age exhibited decreased cognitive development, despite long-term outreach intervention programs. Earlier age of onset of growth failure, lower maternal education level, and lower family income all predicted lower cognitive level.