‘Failure to thrive’ revisited

The term ‘non‐organic failure to thrive’ (FTT) has long been used in relation to young children with faltering growth for which no organic cause is found. In this paper, problems arising from dichotomised organic/non‐organic responses to FTT are explored and reasons for the assumption that non‐organic FTT was always due to emotional abuse or neglect are presented. The case is made that, except in a minority of cases, children fail to grow because they consume insufficient calories. Research studies on reasons for poor intake, from factors related to the child and their parents to the wider family and environment, are summarised. Following a brief reference to literature on outcomes, I argue that centile charts should be routinely completed for all young children. If faltering growth is identified, a multi‐factorial assessment should be undertaken. Such an assessment reduces the risk of interventions being based on outdated assumptions about non‐organic FTT and maximises the potential for successful resolution of poor growth. After briefly summarising the literature on interventions, I conclude with suggestions for improving practice in this field, including working in partnership with families and with health and social care professionals already known to them. Copyright © 2008 John Wiley & Sons, Ltd.