A community based study of failure to thrive in Israel.

Abstract

Objective-To examine the characteristics of infants suffering from failure to thrive in a community based cohort in Israel and to ascertain the effect of failure to thrive on their cognitive development. Methods-By review of records maintained at maternal and child health clinics in Jerusalem and the town of Beit Shemesh, epidemiological data were obtained at age 15 months on a cohort of all babies born in 1991. For each case of failure to thrive, a matched control was selected from the same maternal and child health clinic. At age 20 months, cognitive development was measured, and at 25 months a home visit was carried out to assess maternal psychiatric status by questionnaire, and the HOME assessment was performed to assess the home environment. Results-3.9% of infants were found to have fallen below the third centile in weight for at least three months during the first year of life. Infants with failure to thrive did not differ from the general population in terms of obstetric or neonatal complications, birth order, or parents' ethnic origin, age, or years of education. The infants with failure to thrive did have lower birthweights and marginally smaller head circumferences at birth. Developmental assessment at 20 months of age showed a DQ of 99.7 v 107.2 in the matched controls, with 11.5% having a DQ below 80, as opposed to only 4.6% of the controls. No differences were found in maternal psychiatric problems as measured by a self report questionnaire. There were, however, significant differences in subscales of the HOME scale.

Oral‐motor dysfunction in children who fail to thrive: organic or non‐organic?

“…Prenatal and perinatal risk scores were higher for those children with OMD, although the differences were non-significant. However, given the power to detect differences of our small subsample size, this could suggest a 'biological vulnerability', a theory proposed by Altemeier et al (1985) and discussed more recently by Wilensky et al (1996). Children with OMD also had significantly higher scores on the Waldrop scales.…”

“…Skuse et al (1992Skuse et al ( , 1994 and Wilensky et al (1996) have shown that children with FTT had significantly lower scores on the Bayley Scales of Mental Development than a matched comparison group of children with normal growth. However, the FTT children with OMD had only marginally lower scores on both the MDI and PDI of the Bayley Touwen (1976) and Amiel Tison and Grenier (1986).…”

“…Ramsey et al (1993) suggested that almost half the children they assessed with NOFT had a history of questionable 'neurological involvement' in the absence of any diagnosable condition. Recently Wilensky et al (1996) found that significantly more of the children they studied with FTT had a history of hypotonia reported in the first year of life compared with normal infants. The gross and fine motor function measures used in our study did not significantly differentiate FTT children with OMD from those with normal oral-motor function, although children with OMD did have slightly higher abnormality scores.…”

Failure to thrive in a population context: two contrasting studies of feeding and nutritional status

“…A few such studies have been undertaken Skuse et al 1994;Wilensky et al 1996), but even fewer studies have included any sort of dietary assessment . For our programme of work in Newcastle we established a district-wide screening programme to allow the identification of all children meeting the screening definition of FTT, without the necessity of formal referral.…”

The psychology behind growth faltering

“…The more new tastes given during the weaning process, the more likely it is that an infant will accept another new food when it is offered to them. Weaning onto a wide range of foods therefore predicts better acceptance in infancy, and children who show growth faltering have been shown to be less likely to take a wide range of foods (Wilensky et al, 1996).…”