Failure to Thrive

The establishment of consistent weight gain with oral feedings is a standard criterion for discharge from the hospital for most premature infants. However, this does not ensure that the pattern of weight gain will continue following discharge. Failure to thrive may occur either because of an ongoing chronic disease (e.g., bronchopulmonary dysplasia, malabsorption, or central nervous system disease) or because of dysfunctional parenting. NICU graduates should be consuming at least 150 mL/kg/day of a standard formula if not breast feeding and should be consistently gaining approximately 20 to 30 g/day. A comparison of the current weight with the discharge weight (which parents usually remember) allows for a quick evaluation of this problem, or appropriate growth curves can be utilized. 89 Any infant with failure to thrive requires a thorough diagnostic evaluation and often hospitalization for accurate documentation of caloric intake. It should be remembered that prematurity itself is not an adequate explanation for postdischarge failure to thrive.

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