Failure to thrive medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S[2]

Overview

Appetite stimulants such as cryptoheptadine and progesterones may be employed in patients with failure to thrive. However, these are not recommended. Medical therapy employed also depends on the underlying organic cause.

Medical Therapy

  • Discussing the specific treatment for organic causes of failure to thrive is beyond the scope of this chapter.
  • However, regardless of the cause, treatment of failure to thrive is always based on three basic principles ; a multidisciplinary approach aimed at treating the underlying cause, facilitating catch up growth via a nutritional rehabilitation program and a period of follow up thereafter.
  • One really needs to look at the bigger picture as the real treatment begins when the child leaves the hospital. [1]
  • First, stabilize the patient from complications such as electrolyte derangements, hypothermia, shock, sepsis, renal failure, etc. Depending on the suspected organic cause, laboratory investigations are then sent. "Failure To Thrive - StatPearls - NCBI Bookshelf".
  • In chronic cases of failure to thrive, a nutritionist, psychologist and social worker should be added to the treatment team.
  • Following the period of hospitalization, the follow up visits are essential in monitoring any relapses and adjusting the plan according to status of the patient.
  • They should be arranged from weekly to every few months depending on the age of the child (infants require more regular visits as compared to older children).
  • Cryptoheptadine or mesogestrol have been used at times, but in general, appetite stimulants are not preferred n patients with failure to thrive.
  • Based on the organic cause or complication, medical therapy is given.
  • Iron deficiency anemia is the most common complication and iron supplements are given.

References

  1. Goldbloom RB (1982). "Failure to thrive". Pediatr Clin North Am. 29 (1): 151–66. doi:10.1016/s0031-3955(16)34114-1. PMID 6276853.

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