Long term outcomes for failure-to-thrive infants

[Quintanimo]

Anyone want to discuss weight charts/feeding choices and long term health?

For example here they collated the resuts of many previous studies - and suggested that FTT cost the infant 3 IQ points. This was not viewed as statistically significant - particularly as their methodology did not allow them to exclude babies who turned out to have underlying illness (approx 10% of hospitalized cases) and/or other adverse circumstances.

[squizita]

3 IQ points in real terms is much less than a GCSE or A level grade, and parenting/teaching/coaching have a bigger impact than 3 if well done.

Reassuring.

Also worth noting some ethnicities grow differently to the charts - so for example the mix of ethnicity in my dad's family meant almost all have been considered too small/slow to grow ... when in the uk. However all grow up to be perfectly healthy with average - high IQ (going by career and education) albeit shorter than most white British people. The number of times I've had to explain to hcp I'm not white British with dark hair (because of genetic conditions and tests around pregnancy) was annoying - and now I have a slow growing but developmentally normal infant. As expected from family history!

[Eastpoint]

This is anectdotal but my friend's son had failure to thrive & was in & out of hospital as a young baby (months not week's old). He has dyslexia & dyspraxia but has completed a 4 year degree. Height is what you'd expect from looking at his parents, I don't know if there is any family history of dyslexia but I suspect so.

[squizita]

Interesting too how they can't diagnose ftt. My dd would fit The definition using some criteria (she's under 5th percentile) but not others.

And of course some of the studies made the connection to maternal height and IQ. Thankfully most HV and GPS make this rather sooner ... 5 foot 7 stone mum = small child.

[Quintanimo]

That's the thing about measured negative outcomes.

Does falling through the centiles stunt a baby's development? Or is the point that it is a useful early indicator for some diseases... May give a clue if there is a problem at home such as feeds made up wrong ..... But beyond that is largely fine within much wider tolerances than currently used as FTT benchmarks...?

[squizita]

Exactly.

And as soon as I clocked the IQ stats for the control group I thought "oh they haven't used a cross section of society" as they're so low for age. It would suggest perhaps poverty and thus maybe other issues as well as just being a shortarse baby.

[tiktok]

It's a tricky thing to track - bedevilled with all sorts of factors that skew results.

There is no ethnic component to growth in infancy and toddlerhood, though, squizita. The major data collection that led to the WHO charts came from different settings, deliberately chosen for their diversity, and they discovered that while ethnicity had an influence on size at birth, it did not have an influence on rate of growth thereafter. This was important to know, because slow-growing babies were being missed by HCPs.....'it's ok for this baby not to gain weight because his parents are vietnamese' or whatever. No, it's not ok - or rather it might be ok, but not because of ethnicity.

There seems to be a bit of heredity in slow growth - siblings and close relatives seem to share the tendency. And of course in a western setting with healthy, normal parenting, slow growth can be monitored, and most of these babies are fine.

But it's not ethnicity, and if we assume it is, we will miss babies who genuinely need some sort of intervention, or further investigation.

Will try and find a link that shows an explanation of the research.

[tiktok]

www.rcpch.ac.uk/system/files/protected/page/DoH%20info%20for%20healthcare%20professionals.pdf explains the charts are to be used as they are, whatever the ethnicity of the child.

[squizita]

That's interesting - anecdotally a lot of friends and family seem to have healthy but slower growing babies so there just seemed to be a correlation.
What is the current definition of failure to thrive?
According to several of those papers my dd is ftt (under 5th percentile - though born small, has slowly drifted to the brink of 2 percentile lines over 9 months) however as she has always gained, appears robust and I am short HV have not considered her as such.
Should I contact my GP directly?
I get worried if she gets constipated because I've read about digestive issues - but my hv team assure me many weaning babies have this and she's eating/digesting fine as she looks well nourished though on the slim side and doesn't fuss or cry.

[tiktok]

Your baby's ok, squiz! Most slow growers are. There's no universal definition of ftt anyway. Some authorities distinguish ftt from 'faltering growth' which is descriptive and not diagnostic.

[squizita]

Yes I suppose I'm lucky the senior hv are level headed about it as I wouldn't want her prodded and tested by Drs without reason.