Intimate partner violence and failure to thrive

Failure to thrive is best described as inadequate growth or the inability to maintain growth, usually in early childhood. It is a sign of under nutrition (Gahagen, 2006; Levy, A., Levy, A., & Zangeten, 2009). In the United States, FTT is seen in 5-10% in primary care settings and in 3-5% in hospital settings (Cole & Lanham, 2011; Daniel, Kleis & Cemeroglu, 2008). Traditionally, the causes of FTT were subdivided into organic (medical) and nonorganic (social or environmental). There is increasing recognition that in many children the cause is multifactorial and includes biologic, psychosocial, and environmental contributors (Edmond, Drewett, Blair, & Emmett, 2007).  Furthermore, in more than 80% of cases, a clear underlying medical condition is never identified (Gahagen, 2006; Stephens, Gentry, Michener, Kendall, Gauer, 2008).

An increasing body of evidence shows links between women’s Intimate Partner Violence victimization and poor child health outcomes  (Whitfield, Anda,  Dube, Felittle ,2003; Anda, Block, & Felitti, 2003; Noland, Liller, McDermott, Coulter, & Seraphine, 2004; Whitaker, Orzol, & Kahn,2006).  The United Nations Children Education Fund estimates that about 275 million children are exposed to intimate partner violence worldwide, with the U.S contributing 5.7 %( 15.5 million) annually. 

Methods: Pertinent articles that were published from January 2005 to 2013 and contained the terms “failure to thrive”, “under nutrition”, “malnutrition”, “intimate partner violence”, “domestic violence”, “family violence” and “children”.  The articles were retrieved by a search in the Pubmed, Ovid MEDLINE, CINHL and Cochrane databases.  A total of 25 articles were reviewed.

FindingsFailure to thrive is recognized to reflect relative under nutrition, however there is no consensus regarding a specific definition.  Children who are exposed to family violence suffer from symptoms of post-traumatic stress disorder, such as bed-wetting or nightmares, and are at a greater risk than their peers of having allergies, asthma, gastrointestinal problems, headaches and flu (Graham-Bermann, & Seng, 2005).  Children of mothers who experience prenatal physical domestic violence are at increased risk of exhibiting aggressive, anxious, depressed or hyperactive behavior (Whitaker, Orzol, & Kahn, 2006).  Witnessing the mental and/or physical abuse of their mother has negative consequences on the children such as increased risk of developing emotional and behavioral problems (Holt, Buckley & Whelan, 2008).  Additionally, children exposed to intimate partner violence have elevated heart rates and increased salivary cortisol levels compared to those not exposed (Saltzman, Holden and Holanan, 2005).

Conclusion: Most articles have examined negative health effects of children’s exposure to and witnessing IPV and the majority of them have focused on birth outcomes or on the health of older children between 5-12 years.  Few studies have been conducted on intimate partner violence and growth failures on children less than two years of age.