• on average 150-200g / week

• doubling of birth weight achieved by age 4-5mo

• tripling of weight by 12mo

Organic

• any chronic disease will cause FTT

• consider:

  • FBC

  • urinarlysis

  • urine culture

  • ensure guthrie card done

  • exclude urinary tract

• Failure of intake

  1. underfeeding

  2. congenital abnormal

     1. clef palate

  3. dyspnoea

     1. congenital heart disease

  4. neurological lesions

     1. cerebral birth injuries

  5. behavioural factors

• Abnormal losses

  1. vomiting

     1. pyloric stenosis

     2. galactosaemia

  2. stools

     1. steatorrhoea

  3. urine

     1. kidney disease

• Failure of utilisation

  1. chronic infection

     1. cystic fibrosis

  2. metabolic disorders

     1. PKU

  3. endocrine disorders

     1. hypothyroidism

  4. constitutional

     1. down syndrome

• Sleep apnoea

Non-organic

• emotional deprivation

  • factors influencing bonding

    • parents

      • expectation of child

      • desire for child

      • capcity to give

      • ego-strength to adapt to stress

      • ability to accept imperfection

      • realistic fantasies of child

    • child

      • absence of defects

      • ability to match parents’ expectation

      • good health

      • loving behaviour,

        • smiling

        • cuddling

        • thriving

• poor nutrition from inadequate intake