Failure to Thrive as Distinct From Child Neglect

Abstract

To the Editor .— As pediatricians and psychologists who have conducted research involving children with failure to thrive (FTT) and/or treated literally thousands of children with FTT, we wish to share our concerns regarding the report “Failure to Thrive as a Manifestation of Child Neglect”1 from the American Academy of Pediatrics (AAP) Committee on Child Abuse and Neglect and Committee on Nutrition. Six aspects of the report are particularly troubling. First, the report does not make it sufficiently clear that FTT as a manifestation of child neglect represents a minority of children with FTT. We agree that, in some cases, FTT may be a marker of neglect and that the diagnosis of abuse and/or neglect should be considered if there is any history of “intentional withholding of food from the child; strong beliefs in health and/or nutrition regimens that jeopardize a child's well-being; and/or family that is resistant to recommended interventions despite multidisciplinary team approach.” Indeed, children with both FTT and neglect have lower cognitive skills initially and years after treatment …