FAILURE TO

THRIVE
 Failure to thrive (FTT) indicates
insufficient weight gain or
inappropriate weight loss
in pediatric patient unless the
term is more precisely defined.

 In children, it is usually defined

in terms of weight, and can be
evaluated either by a low weight
for the child's age, or by a low
rate of increase in the weight.
 A descriptive term, not a specific diagnosis

 Failure to thrive (FTT) is the result of inadequate

usable calories necessary for a child metabolic
and growth demands, and it manifests as physical
growth that is significantly less than that of
peers.
  Inadequate calorie intake :
Incorrect formula Preparation , Gastroesophageal reflux , Inadequate breast milk supply ,
Mechanical feeding difficulties (e.g. : cleft lip or palate ) , Poor oral neuromotor
coordination, Neglect or abuse ,Toxin induced gastrointestinal (e.g. :constipation )

 Inadequate absorption :
Celiac disease ,Cystic Fibrosis , Crohn’s Disease , Vitamin or mineral deficiencies
,CMPA, Biliary Atresia , Hepatic disease.

 Increased Metabolism :
Hyperthyroidism , congenital Heart Disease or chronic immunodeficiency

 Defective utilization of calories :

Genetic Anomaly , Congenital Infection or Metabolic storage disease
MEDICAL CAUSES OF FAILURE TO THRIVE :
 Problems with genes, such as (Down Syndrome )
 Organ problems
 Hormone problems
 Damage to the brain or central nervous system, which may cause feeding
difficulties in an infant
 Heart or lung problems, which can affect how nutrients move through the
body
 Anemia or other blood disorders
 Gastrointestinal problems that make it hard to absorb nutrients or cause a
lack of digestive enzymes
 Long-term (chronic) infections
 Metabolism problems
 Problems during pregnancy or low birth weight
FACTOR IN THE ENVIRONMENT INCLUDE:

 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
 Enteral feeding is a way to feed your child using
a feeding tube. Enteral feedings will become
easier for you to do with practice. Your health
care provider will go over all of the steps you
should follow to deliver the feedings. learn to
how care for the tube and the skin, flush the
tube, and set up the bolus or pump feeding.
INSTRUCTION IF THE TUBE IS CLOGGED OR PLUGGED:

I. Flush the tube with warm water.

II. If you have a nasogastric tube, remove and replace the tube (you will need to measure
again).
III. Make sure any medicines are crushed properly to prevent clogging.

INSTRUCTION IF THE CHILD COUGHS OR GAGS WHEN YOU INSERT THE NASOGASTRIC
TUBE:

I. Pinch the tube, and pull it out.

II. Comfort your child, and then try again.
III. Make sure you are inserting the tube the right way.
IV. Make sure your child is sitting up.
V. Check the tube placement.
INSTRUCTION IF THE CHILD HAS DIARRHEA AND CRAMPING:

I. Make sure the formula is mixed properly and warm.

II. DO NOT use formula that has been hanging for feeding for more than 4 hours.
III. Slow the feeding rate or take a short break. (Make sure you flush the tube with
warm water in between breaks.)
IV. Check with your provider about antibiotics or other medicines that may be causing
it.
V. Start feeding when your child feels better.

INSTRUCTION IF THE CHILD HAS AN UPSET STOMACH OR IS VOMITING:

I. Make sure the formula is mixed properly and warm.

II. Make sure your child is sitting up during feedings.
III. DO NOT use formula that has been hanging for feeding for more than 4 hours.
IV. Slow the feeding rate or take a short break. (Make sure you flush the tube with
warm water in between breaks.)
V. Start feeding when your child feels better.
If the child has a nasogastric tube and skin is irritated :
I. Keep the area around the nose clean and dry.
II. Tape down over the nose, not up.
III. Switch nostrils at each feeding.
IV. Ask your doctor about a smaller tube.
 The child with gastrostomy tube (G-tube) is
a special tube in a stomach that will help
deliver food and medicines until your child
can chew and swallow. Sometimes, it is
replaced by a button, called a Bard Button
or MIC-KEY, 3 to 8 weeks after surgery.
 Clean the skin around Gastrostomy tube 1 to 3 times a day with mild soap and
water.
 Try to remove any drainage or crusting on the skin and tube. Be gentle. Dry the
skin well with a clean towel.
 The skin should heal in 2 to 3 weeks.
 Your provider may also want you to put a special absorbent pad or gauze around
the G-tube site. This should be changed at least daily or if it becomes wet or
soiled.
 DO NOT use any ointments, powders, or sprays around the Gastrostomy tube.
 Open the flap and insert the bolus feeding tube.
 Insert the syringe into the open end of the extension set and clamp the
extension set.
 Pour the food into the syringe until it is half full. Unclamp the extension set
briefly to fill it full of food and then close the clamp again.
 Open the button flap and connect the extension set to the button.
 Unclamp the extension set to begin feeding.
 Hold the tip to the syringe no higher than your child's shoulders. If the food is
not flowing, squeeze the tube in downward strokes to bring the food down.
 A jejunostomy tube (J-tube) is a soft, plastic tube placed
through the skin of the abdomen into the midsection of the
small intestine. The tube delivers food and medicine until the
person is healthy enough to eat by mouth.