Your child may appear as though they’re thriving. They’re eating dinner with everyone else, making friends on their sports team, doing well in school—but that doesn’t mean they’re thriving developmentally. When a child isn’t growing, it’s called Failure to Thrive (FTT), and Children’s Hospital of Philadelphia defines it as:

“Decelerated or arrested physical growth (height and weight measurements fall below the third or fifth percentile, or a downward change in growth across two major growth percentiles) and is associated with abnormal growth and development.”

If you’re not sure whether your child is growing properly, or have a gut feeling they’re not, look for these signs and then take the next steps.

The Signs

There are a number of signs to look for if you’re worried your child isn’t thriving. If you suspect this may be something your child is struggling with, here are five signs to look for.

1. Not Eating Enough

If your child isn’t eating enough, they’re likely not getting the nutrients they need to grow, including vitamin A, vitamin D, protein, healthy fats and carbohydrates—among many others. If this is the case, remember to pack snacks in your bag or theirs, or keep bags of nuts or crackers in the car at all times. As you’re bouncing from place to place, you can make sure there’s food for your little one, regardless of where you are.

2. Undiagnosed Digestive Disorders

If your child is eating enough, but not absorbing the nutrients, they could be struggling to grow properly. This is often caused by digestive disorders that have gone undiagnosed: “Disorders affecting lining of the bowel, including celiac disease or Crohn’s disease can also cause children to have poor weight gain. In celiac disease, symptoms start when foods that contain gluten are introduced into the diet,” explain health experts at Cleveland Clinic.

Conversely, Cleveland Clinic suggests they could also be:

  • Burning more calories than normal, which could be caused by an over-active thyroid gland.
  • Throwing up too much, due to severe acid reflux.
  • Unable to digest food because of an underperforming pancreas.

3. Environmental Challenges

FTT isn’t always caused by not eating enough or suffering from an undiagnosed digestive disorder. This can occur in children from exposure to a wide variety of environmental factors. According to the Medlineplus.gov, these factors could be:

  • Loss of emotional bond between parent and child
  • Poverty
  • Problems with child-caregiver relationship
  • Parents do not understand the appropriate diet needs for their child
  • Exposure to infections, parasites, or toxins
  • Poor eating habits, such as eating in front of the television and not having formal meal times

4. Mood and Attitude

Your child’s mental state may be an important indicator that they’re suffering from FTT. According to Children’s Hospital of Philadelphia, the signs to look for include:

  • Irritability
  • Easily fatigued
  • Excessive sleepiness
  • Lake of age-appropriate response
  • Behavior difficulties later in childhood 

5. Low Birth Weight

This is a risk-factor, rather than a sign, but still important to keep in mind if you’re worried that your child may be suffering from FTT. The U.S. National Library of Medicine reports:

“16% of extremely low birth weight infants are small for gestational age at birth, but by 36 weeks corrected age, 89 percent have growth failure. Follow-up at 18 to 22 months corrected age shows that 40 percent still have weights, lengths, and head circumferences less than the 10th percentile.”

My Child Isn’t Thriving: Now Why?

The moment you notice a drop in weight or loss of appetite, make a doctor’s appointment. Your child’s primary care doctor can diagnose your child by looking at a wide range of symptoms. According to the guide, What is Failure to Thrive, your health professional will be looking at:

  • Weight-for-age less than the 5th percentile
  • Low weight-for-height ratio
  • Height-for-age less than the 5th percentile
  • Weight that suddenly drops more than 2 percent on growth curve
  • A stall in linear growth
  • Developmental delays or not meeting milestones
  • Medical diagnosis or tests

The FTT guide explains that they need to look at all these growth benchmarks because many babies exhibit at least one symptom: “It is important to note that low body weight or a short height-for-age does not immediately indicate failure to thrive. During the first year of life, 27 percent of infants have been found to meet at least one criteria for FTT, which is why doctors use multiple criteria to make an official diagnosis.”

If your child does in fact have FTT, there are a number of potential outcomes. John Hopkins Medicine suggests that they may be hospitalized initially to start the new treatment plan. However, if it’s not severe, you may simply be able to take the next steps with guidance from your child’s doctor. For cases in which there are other issues at play, like undiagnosed disorders, you may be referred to other specialists, such as a dietician or gastroenterologist to address underlying problems.

Help Your Child Thrive and Grow

If you notice your child isn’t eating a lot, or has other issues, like regularly throwing up, they may need treatment for FTT. Keep these signs and symptoms in mind, and visit the doctor right away if there’s any hesitation. With intervention, most children return to normal height and weight quickly, allowing them to be their best, growing selves.

BIO: Jessica Thiefels has been writing for more than ten years and is an ACE Certified Personal Trainer and mental health advocate. She’s written for Shape, Reader’s Digest, AARP, Snap Fitness, 24 Hour Fitness and more. Follow her on Twitter and Instagram.

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