Failure To Thrive: What Is It and What Can You Do?

Failure to thrive definition, signs, treatments.
What is failure to thrive?. Ariel Skelley/Blend Images/Getty Images

Typical Newborn Growth

Regardless of how a baby is fed, a child typically doubles his birth weight in 4 months and triples it by the age of 1 year. Breastfed babies should be back to their birth weight in 2 to 3 weeks, but when feeding well, most babies will be back to their birth weight before that.

It is normal for your newborn to lose weight in the hospital during the first few days after birth. And, if you receive intravenous (IV) fluids during your labor, your baby might lose more than the average.

It is important to keep in mind that "normal" growth is individual, with heredity and genetics playing a large part. Infant growth patterns vary, so well-child visits to the pediatrician are essential to check for healthy growth and catch any potential problems as soon as possible. 

Your child's doctor will graph your child's growth and you should be able to see a steady an increase of weight over time.  A consistent amount of weight gain shows that your child is getting enough nutrition.   

Failure To Thrive: What Does It Mean?

When a child is losing weight or not gaining weight at a steady, healthy pace, it could mean that she is not getting enough nutrition, or she has a health issue that is preventing healthy growth.  The medical term given for this condition is failure to thrive, or FTT.

Failure to thrive can be seen in older children who are malnourished or severely ill, however, it is more often seen in newborns and young infants.

 Failure to thrive is dangerous and should be treated as soon as possible.

Signs Of Failure To Thrive For Newborns 

  • Weight loss that continues beyond the first 10 days after birth.
  • Failure to return to the birth weight by the age of 3 weeks. 
  • After the first month of life, continually falling below the 10th percentile for weight gain. 

    What Causes Failure To Thrive In Newborns and Infants?

    Weight loss or poor weight gain in newborns and infants can have many causes.  The most common cause for failure to thrive is not getting enough calories and nutrition. This can be due to an infection, or a hormonal issue. Poor absorption of nutrients through the baby's digestive tract could also cause problems. For breastfeeding babies, it could be from not getting enough breast milk, or not breastfeeding often enough.  

    What Can You Do?

    Work With Your Healthcare Team

    Failure to thrive is a scary, complicated problem that can affect the long-term health and development of your child. When a child has a health problem, it is a very upsetting and guilt-ridden time for a family. It probably goes without saying that feeding the baby is of utmost importance, and it is necessary that a team of professionals -- doctor, nurse, social worker, dietitian, and psychologist -- is involved.

    It is also recommended to include a lactation consultant in the care plan.  A lactation consultant will observe:

    • Your baby's suckling and whether or not he's willing to do so
    • Your comfort
    • Your breastfeeding position
    • Your baby's body position
    • Eye contact between you and your child
    • How long a feeding lasts
    • How the baby swallows

    The lactation consultant may recommend that you weigh your baby every day at the exact same time and record that weight.  She can also show you how to record other important information such as how much your baby is nursing and how often he is wetting or soiling his diapers.


    Cole, SZ, Lahnam JS. Failure To Thrive: An Update. American Journal of Family Physicians. 2011; 83 (7): 829-834.

    Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Seventh Edition.  Mosby. 2011.

    Pediatrics in Review. 1997;18:371-378.

    Edited by Donna Murray

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