Paper
Thursday, July 12, 2007
Caregiving of Children with Failure to Thrive: A multidisciplinary team approach
Kathleen P. Falkenstein, PHD, CPNP, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
Failure to thrive (FTT) has a prevalence rate of 3% to 10% in rural and urban populations. As an indicator of physical and psychosocial problems, FTT is associated with subsequent growth delay and cognitive deficiencies. FTT in low income communities can represent the “tip of the iceberg” and many children experience food insecurity which may act as a precursor to FTT. Children with FTT require prompt attention and caregiving by a multidisciplinary team to prevent the long term consequences on growth and development. This paper examines the effects of a multidisciplinary approach by the GROW CLINIC to manage children with FTT. Members of the team include a pediatrician, nurse practitioner, nutritionist, psychologist, and social worker. The goal is to prevent the long-term health and developmental effects from FTT and its associated family dysfunction. Method: A descriptive design was used. One hundred forty six children and families were evaluated.
Results: All of the children have weights of less than the 5th percentile at the time of referral (mean age was 18 months). Twenty percent have been diagnosed with organic FTT (GER, asthma); 92% have psychosocial issues impacting their FTT (unstructured meals, food insecurity, behavior issues); 96% have excessive fluid intake. One third of the children have developmental delays or behavior issues. Social services have been implemented in more than 60% of the families. About 80% of the families have been referred to community organizations. With a multidisciplinary approach, more than 85% of the children have gained an appropriate amount of weight for age (g/d) and have improved behaviors (mealtime structure, juice intake).
Conclusion: Caregiving by this multidisciplinary team has made a major impact on both anthropometric and behavior change in children with FTT and their families. The long term effects of this approach are being evaluated in this population.