Page 207 - Encyclopedia of Nursing Research

174 n FAILurE TO THrIVE (CHILd)

functioning as the primary characteristic loss due to acute illness. When a child’s
of FFT and measured associated factors in lack of weight gain is attributed to psycho-
F 34 older adults admitted to rehabilitation social factors and developmental concerns
therapy posthospitalization (Higgins & daly, rather than organic or disease-related fac-
2005). Findings indicated that participants tors, the term FTT is used. Within the last
with unexpectedly low physical functioning few years, researchers have begun to refer
were older, had decreased serum albumin to FTT as “faltering growth,” because many
levels, depressed mood, and less likelihood connote the term FTT with the occurrence of
of discharge home. maternal neglect or abuse; the term faltering
Adult FTT is not normal aging, the growth does not hold the same negative con-
unavoidable result of chronic disease, or a notations (Batchelor, 2008).
synonym for the terminal stages of dying Traditionally, the FTT syndrome has
(Egbert, 1996). Although there is no univer- been classified into two categories: organic
sally accepted definition, it appears that adult, and nonorganic. Although the term FTT
or geriatric, FTT is a multidimensional con- is used in contemporary literature, most
cept more accurately defined as a syndrome researchers agree that the classification is not
rather than a medical diagnosis. In fact, it is a so clear; especially because all cases of FTT
particularly unhelpful diagnosis if it is used have an organic etiology (i.e., undernutrition;
to provide a label for unspecified symptoms Olsen et al., 2007).
and, consequently, prompts a sense of fatal- FTT is a common problem of infancy
ism in clinicians, patients, and/or family and early childhood, and researchers have
(robertson & Montagnini, 2004; rocchiccioli documented a dramatic increase in its inci-
& Sanford, 2009). rather, we need more mea- dence since the late 1970s. FTT is most com-
surement-oriented approaches that establish mon during infancy, when nutritional needs
the syndrome’s complex underlying factors and growth are at their highest point.
and determine appropriate treatments. FTT accounts for 3% to 5% of the annual
admissions to pediatric hospitals and approx-
Patricia A. Higgins imately 10% of growth failure seen in outpa-
tient pediatrics (Schwartz, 2002). Infants with
FTT typically present not only with growth
failure, but also with developmental and
Failure to thrive (child) cognitive delays and signs of emotional and
physical deprivation, such as social unre-
sponsiveness, a lack of interactive behaviors,
Failure to thrive (FTT) is a term used to and anorexia (Sullivan & Goulet, 2010).
describe a deceleration in the growth pat- Infant factors contributing to FTT
tern of an infant or child that is directly include poor appetite regulation (e.g., not
attributable to undernutrition (Steward, waking for feedings), weak suck, difficulty
ryan-Wenger, & Boyne, 2003). Typically, the weaning to solid foods, sensory sensitivity,
deceleration is a growth deficit whereby the and poor oral-motor coordination (e.g., swal-
rate of the child’s weight gain is below the lowing or chewing difficulties; Harris, 2010).
5th percentile for age, based on the National Parental factors contributing to FTT include
Center for Health Statistics standardized strategies to increase food intake, such
growth charts. undernutrition, or caloric as force-feeding or extending the period
inadequacy, and thus a deceleration in a between feedings to ensure the child will be
child’s growth pattern, can occur because of hungry. These strategies can exacerbate the
any number of physiological reasons, such as problem and also result in increased anxi-
nutrient malabsorption or transient weight ety in the parent/child dyad (Harris, 2010).