Obesity Outcomes in Children With a History of Failure to Thrive

Background: There are numerous outcome studies on the neurodevelopmental and growth sequelae of children with failure to thrive (FTT). Most research demonstrates adverse outcomes in neurodevelopment and behavior.1,2 However, the results on long-term growth are discrepant. The majority of studies demonstrate that infants with FTT remain small throughout life, although meta-analyses suggest that growth parameters may normalize over time.3,4 There are no reports on the long-term outcome of obesity in this population. This finding would have important implications for the approach and management of FTT. If clinicians are too aggressive in nutritional repletion, this may lead to overcorrection and obesity; but inadequate intervention could lead to poor developmental outcomes. Methods: Experienced clinician recall identified a paradoxical outcome of obesity for a subgroup of children with a history of FTT. The study setting is an inner city, tertiary care childrens hospital and the time period of review was between 1990 and 2011. Subjects were infants with nonorganic FTT diagnosed prior to age 2 years, and with subsequent childhood or adolescent obesity.