Nutrition: Foundations for Life
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What else might contribute to failing to thrive?
Psychosocial issues must be considered during a work-up for failure to thrive. If no organic cause can be found, failure to thrive may be rooted in poverty, family dysfunction, poor parenting skills which contribute to inadequate caloric intake, and/or complex interactions involving stress responses even in the presence of adequate calories. In some situations, the child may fail to thrive until removed from the non-nurturing environment. In many cases the etiology is complex (i.e. organic and non-organic) and solutions are not simple.
Economic stress may tempt a parent to dilute formula to make it last as longer. Thankfully, with the advent of nutritional support programs in the United States (e.g. WIC), this is less of a problem than it once was. However, whenever evaluating a child for failure to thrive, a complete history should include formula preparation technique and a thorough dietary history.