Nonorganic failure to thrive

Alternative names

Maternal deprivation syndrome

Definition

Maternal deprivation syndrome is a failure to thrive caused by neglect (intentional or unintentional).

Causes, incidence, and risk factors

The majority of cases of failure to thrive (FTT) in infants and young children (under 2 years old) are not caused by disease.

Approximately two-thirds of all cases are caused by dysfunctional caregiver interaction, poverty, child abuse, and parental ignorance about appropriate child care.

Failure to thrive in children less than 2 years old is defined as failure to gain adequate weight, failure of linear growth, and failure to achieve some or all developmental milestones.

The health care provider may see poor hygiene, inappropriate clothing, and general lack of care. A parent may feed the child an unusual or overly restricted diet. Although the mother or other primary caregiver may appear concerned, the interplay and physical contact normally seen between mother and infant may be absent or distorted.

Factors that may contribute to nonorganic failure to thrive include:

• Young age of parent (teenage parents)
  
• Unplanned or unwanted pregnancy
  
• Lower levels of education (especially failure to complete high school)
  
• Lower socioeconomic status
  
• Absence of the father
  
• Absence of a support network (family, close friends, or other support)
  
• Mental illness, including severe post-partum depression
  

Symptoms

• Weight less than the 5th percentile, or an inadequate rate of weight gain
  
• Decreased or absent linear growth ("falling off" the growth chart)
  
• Lack of appropriate hygiene
  
• Subtle-to-blatant abnormalities in the interaction between mother and child
  

Signs and tests

Diagnosis of FTT begins with a thorough history and physical along with meticulous examination of the patient's growth chart.

When the diagnosis is suspected, important information may often be obtained by admitting the infant to the hospital where, with adequate feeding and care, weight gain and resumed growth may be demonstrated in a matter of days. Often as little as 3 or 4 days of hospitalization may demonstrate renewed weight gain.