The most common cause of failure to thrive is inadequate calorie intake. This may be secondary to psychological causes, poor environmental status, poor calorie absorption and underlying medical conditions that cause excessive energy expenditure.

• The most common cause of failure to thrive is inadequate calorie intake. ^[1]
• This may be secondary to psychological causes, poor environmental status, poor calorie absorption and underlying medical conditions that cause excessive energy expenditure. ^[2]
• The pathophysiology of failure to thrive is a culmination of environmental, psychological, pathological and nutritional factors.
• In terms of the pathophysiology, failure to thrive is a contributing rather than an exclusive cause of the patient’s over all condition.
  • A healthy, disease free, stressor-free, clean environment should be maintained for adequate growth of the child. Absence of this contributes to failure to thrive. ^[3]
  • Increased parental conflict, decreased discipline where feeding techniques are concerned, poor education, separation, emotional deprivation, use of alcohol, tobacco or illicit drugs are psychological contributors to failure to thrive.
• It is beyond the scope of this page to explain the pathophysiology of every organic cause.^[4]
• However, malabsorption syndromes, cystic fibrosis, pancreatic insufficiency, malignancies, congenital heart disease, immunodeficiencies causing recurrent infections, intestinal obstructions and chronic respiratory disease are some common organic pathologies that cause either impaired calorie absorption or increased calorie demand.
• But irrespective of the cause, all patients have one thing in common, a treatment strategy which is based on calorie catch up growth and a subsequent prolonged follow up period.
• It is a learning process for the parents and emotions may get the better of them initially. Slow, apathetic babies may be ignored whereas voraciously feeding small for gestational ages may be handled aggressively as they are anxiety/tension provoking.

​