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Dr. Andrew Rynne

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3 year old, under weight, diagnosed with FTT . What treatment should be done?

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Hi, I am curious regarding my niece. She is under wt, has been diagnosed FTT on three sep occasions, is very pickey eater, seen by endo, several peds and no Dr. have given anything other than the diagnosis FTT to my brother and sister in law, they don't know what to do next. She just was ill with the flu and has lost more wt. She is 3 years old and wt is around the 20LB XXXXXXX They just started to give her pedasure through the day in divided doses however are concerned that she is not getting essential nutriens for proper development. She can get behavioural (tempotantrums and will refuse to eat). What should they do? On of the Doc mentioned to possibility of growth hormon use in January if no improvement. Should she been seen by speech path (?oral sensitivity to foods/textures?) I am trying to help them out by researching/contacting Docs for them.
Thanks greately XXXXXXX
Mon, 7 Jan 2013 in Child Health
 
 
Answered by Dr. Rajiv K Khandelwal 5 hours later
Hi XXXXXXX

Thank you for your query concerning your niece.

I can understand failure to thrive (FTT) can be both challenging and frustating for the parents and relatives. FTT can be due to endogenous or exogenous causes. As per your details endogenous causes have been ruled out. As parents and relatives you must be taking abundant care so exogenous factors need not be a cause of concern.

The parents are doing the right thing by giving Pediasure. Growth hormone is not used in suc cases. It should be used only if there is intrinsic growth hormone deficiency. Speech pathologist will not be able to help you in this matter.

My line of management is such cases would be:
1. First of all plot the weight and height parameters on a chart and analyse from when did the faltering of growth started.
2. Do not to force the child to eat. Rather keep the food in front of her at regular intervals and let her have her pick. If she does not have anything to eat then remove the food and offer again after half to one hour.
3. Encourage her to have food which she likes. That food can be fortified to provide more nutrients in a smaller quantity.
4. Let the child have small frequent meals.
5. Cyproheptadine 5 ml. twice a day before meals may be tried to increase the appetite.

I hope I have responded to your query to your satisfaction. Please feel free to revert back in case you need any clarifications or would like to add more facts to the case.

Wishing your niece all the best.

Regards,

RKK
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