Coping When Your Newborn Fails to Thrive

You're radiant with joy, expecting a baby-and anticipation grows along with your pregnancy bump! As the delivery date draws near, your excitement swells… Yet for some parents, this glorious bubble bursts when their baby is born with a health issue that is often termed as "failure to thrive." Imagine the range of feelings-from denial to disbelief, along with anger, disappointment, and fear!

What Is 'Failure to Thrive?'

What does "failure to thrive" really mean, and how can parents cope? Begin with "baby steps"-follow through with any testing the doctors recommend for your baby to discover the underlying health issue. Then learn as much as you can about the health problem and how to treat it. And, start building your support system of friends and family.

A first step is awareness-understanding "failure to thrive." It is defined by The Merck Manual Home Health Handbook as "a delay in physical growth and weight gain that can lead to delays in development and maturation." Typically, this means the baby is losing weight, rather than growing, perhaps due to not feeding adequately, not breathing well, or not meeting all of his/her overall health requirements. Some babies come into this world with jaundice, while others are born with digestive maladies, Cystic Fibrosis, or other lung issues that can prevent them from thriving. With the general diagnosis of "failure to thrive" all possible causes need to be explored.

Testing to Clarify Things

Your next step is to learn what tests may be needed, which may include:

  • Complete Blood Count (CBC)

  • Urinalysis

  • Denver Developmental Screening Test (used to show delays in development)

  • X-rays (to evaluate bone age)

  • Additional testing, if the doctor suspects an underlying disease

Diagnosis and Causes

Another step in coping with a "failure to thrive" diagnosis is to understand how it is determined. It is usually based on a thorough exam, a growth chart comparison, and on answers to particular questions regarding the baby's health and environment. There are many possible causes, such as:

  • Lack of access to proper nutrition for the mother and/or newborn

  • A medical disorder affecting the child's ability to receive and absorb adequate nutrition (e.g., cleft palate, gastro-esophageal reflux, and intestinal malabsorption)

In other cases, it may be caused by hormonal disorders, genetic disorders, or an infection like human immunodeficiency virus (HIV). Here's a list of some other possible causes:

  • Birth defects

  • Cancer

  • Child abuse or neglect

  • Endocrine disease (growth hormone deficiency, thyroid problems)

  • Fetal Alcohol Syndrome

  • Heart and lung diseases (asthma, cystic fibrosis, heart defect)

  • Kidney disease (diabetes, kidney failure)

  • Socio-economic problems

Prognosis and Possible Treatments

If the baby is undernourished, he/she may fall behind others permanently in brain development during the first year. In 50 percent of cases, this development (especially verbal) stays below normal. These individuals often have emotional and social issues into their adult years. Treatment depends on what caused the health problem. If it is from a medical disorder, there are specific treatments. If not, then treatment is based on how far the baby's health is below "the norm" (e.g., If it's "moderate," the child may receive high-calorie feedings regularly). If the problem is ranked as "severe," then the baby may be admitted to the hospital. Specialists in nutrition, psychiatry, and social work coordinate efforts.

How Some Parents Cope

Knowing where to go for emotional, financial and other help is key. Here are some resources:

  • Hospitals and birth centers. Some are better than others at going above and beyond to provide medical help for the baby, and to offer support for parents of newborns with health problems. In most cases, they will provide a list of websites and hotlines that are relevant to the baby's specific health issues.

  • 'Uncle Sam' offers some answers. The Family and Medical Leave Act (FMLA) allows some employees to take a "reasonable" leave (unpaid) to care for family members with medical issues. After completing the necessary paperwork, employees with FMLA coverage may have up to 12 weeks of unpaid "job-protected" leave per year. FMLA requires that the employee's group health plan stays intact during the leave. This applies to all public/private grammar and secondary schools, public agencies, and companies with 50 employees or more. Details are usually available from an employee's human resources department.

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