Failure to Thrive
An 8-year-old boy is referred for moderate failure to thrive. His parents are divorced and he lives with his mother, who has social and financial difficulties, is taking antidepressants, and works six days a week. What is the most appropriate next step in management?
- A.Multidisciplinary team involvementCorrect
- B.Reassurance and routine follow-up
- C.Simple advice to increase caloric intake
- D.Total parenteral nutrition
Explanation
Failure to thrive with significant psychosocial contributors is best managed through a multidisciplinary team addressing medical, nutritional, and social needs. Reassurance underestimates the problem, isolated dietary advice is insufficient, and parenteral nutrition is not indicated for this non-organic picture.
Why each option
- A.
- A multidisciplinary team addresses the medical, nutritional, and social factors.
- B.
- Reassurance alone neglects the psychosocial drivers of failure to thrive.
- C.
- Caloric advice alone does not address the underlying social difficulties.
- D.
- Parenteral nutrition is reserved for severe organic gut failure.
Reference: Nelson Textbook of Pediatrics, 21st ed., 2020
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