Failure to thrive: Current clinical concepts

• Based on consensus, FTT is best considered a physical sign of undernutrition and not a clinical syndrome caused by "organic" or "nonorganic" factors. (1)(2) • Based on strong research evidence, infants and young children may cross major percentile lines on growth curves during a normal course of growth. Therefore, documentation of weights or lengths falling off of growth channels is not, by itself, proof of FTT. (3) • Based on conflicting research evidence, it is unclear how many children have adverse neurodevelopmental outcomes from FTT. (4)(5)(6)(7)(8) • Based on some research evidence, extensive laboratory screening is of little utility in the evaluation of FTT. (12) • Based on some research evidence, certain children who appear to have FTT may be biologically programmed to be smaller and thinner than most children. Insulin resistance may be a mechanism, and aggressive nutritional intervention may put these children at risk of developing metabolic syndrome. (13)(14)(15).