Failure to thrive organic vs Failure to thrive non-organic
How to tell Failure to thrive organic and Failure to thrive non-organic apart when a board question makes them look alike.
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Catch-up weight gain during supervised feeding without new medical findings favors non-organic failure to thrive.
Side by side
Red-flag exam or laboratory abnormalities with poor weight gain suggest an organic medical etiology.
Weight gain improves rapidly with observed structured feeding and no disease markers, supporting non-organic etiology.
Underlying malabsorption, endocrine disease, cardiac disease, or chronic infection increases energy loss or metabolic demand.
Psychosocial stressors, feeding technique errors, or food insecurity reduce effective caloric intake without intrinsic disease.
Organic clues include crossing down more than 2 major percentile lines plus objective abnormalities such as hemoglobin under 10 g per dL, steatorrhea, TSH outside reference range, or sweat chloride 60 mmol per L or higher.
Non-organic pattern often has normal CBC CMP TSH and stool studies, with catch-up gain above 20 to 30 g per day after supervised feeding intervention.
The trap
A common error is labeling all growth faltering as neglect before obtaining focused history, feeding observation, and targeted screening tests. Another error is ordering exhaustive specialty workups when basic intake problems are evident.
The repair move
Next best step: perform structured feeding assessment, dietitian-guided calorie plan around 120 kcal per kg per day, and limited screening labs. If weight gain occurs with support, arrange close outpatient follow-up and social-resource linkage rather than invasive testing.
Try a free question
CoreA 9-month-old infant has crossed from the 40th to 5th weight percentile in 3 months. Exam shows chronic greasy stools and abdominal distension. What is the next best step in management?
Show answer and explanation
Answer: A. Begin targeted organic evaluation for malabsorption. Objective malabsorption clues warrant directed medical workup for organic FTT.
Why the other choices are tempting
- B. Behavioral diagnosis alone misses possible disease.
- C. One-year delay risks prolonged malnutrition.
- D. Stimulants are unrelated to infant FTT management.
- E. Removing nutrition worsens growth failure.
Flashcards
Tap a card to flip it.
What bedside finding strongly favors non-organic failure to thrive?
Rapid catch-up weight gain with supervised feeding and structured routine.
Which test finding strongly pushes toward organic failure to thrive?
Objective disease marker such as abnormal stool fat, endocrine labs, or positive sweat chloride.
Quick answers
What is the fastest way to tell Failure to thrive organic from Failure to thrive non-organic?
Catch-up weight gain during supervised feeding without new medical findings favors non-organic failure to thrive.
What is the key clue for Failure to thrive organic?
Red-flag exam or laboratory abnormalities with poor weight gain suggest an organic medical etiology.
What is the key clue for Failure to thrive non-organic?
Weight gain improves rapidly with observed structured feeding and no disease markers, supporting non-organic etiology.
What is the common trap with Failure to thrive organic vs Failure to thrive non-organic?
A common error is labeling all growth faltering as neglect before obtaining focused history, feeding observation, and targeted screening tests. Another error is ordering exhaustive specialty workups when basic intake problems are evident.