What is Failure to Thrive?
I see clients with their young children who have been given a “Failure to Thrive” (FTT) diagnosis frequently in my office.
“Failure to Thrive” (FTT) is the umbrella term given to babies and children who do not gain weight as expected.
Sometimes, the child’s linear growth (height) is also compromised.
These terms also fall into the FTT category: “small stature,” “low on the growth curve” or “faltering weight.”
FTT as a medical diagnosis rightly frightens many parents and sets a whole host of concerning questions in to motion.
- What if my child isn’t growing properly?
- What have I done wrong to cause my child’s poor growth?
- How can I help my child eat more/better/differently in order to grow “normally”?
And, I understand these worries. But, I am happy to say that a family nutrition approach is an excellent step in the right direction when addressing this problem.
The age of children impacted by FTT is a wide range - from infants to teenagers.
For the content of this post, I am discussing FTT affecting toddlers through school aged children.
Generational Epigenetic Influences on Failure to Thrive
Many things can cause FTT.
In my experience, FTT is a symptom of malnourishment, usually caused by inherited digestive disorders, malnutrition and food intolerances.
For each and every one of us, our health starts with our mom and dad and the health of their own digestive system at the time we are conceived.
Couples who embark upon a preconception nutritional program prior to conception greatly reduce their chances of passing serious digestive ailments on to their kids.
When a man and woman’s DNA join to create a new life, the mix of their DNA plus epigenetic cues are transferred from themselves to their offspring.
Each parent’s diet at the time of conception might cause lasting changes in the DNA of the offspring, potentially influencing their growth and development, according to a study published in Nature Communication.
There is a growing body of information that indicates parental food intolerances and digestive disturbances are being passed on to their children.
This all happens quite quickly in utero.
Foods that mom and dad consumed prior to conception have influenced their own DNA, and in turn, the DNA of their baby, from the very beginning.
If mom (and/or dad) has a history of tummy troubles, food intolerances or nutrient absorption issues, it’s relatively safe to say those will be passed along to the baby.
The genetic component is the code for how the body responds to various factors, the epigenetic component is food as a factor for health or lack thereof.
It’s All About The Timing of Conception
The foods which mom consumes during pregnancy will seal the developmental processes.
By the second trimester of pregnancy, baby’s digestive system’s structures are fully formed and in the right places.
Baby’s digestive tract begins its practice of churning, squeezing, absorbing and expelling around week 13 of pregnancy. And it often mimics the very same digestive patterns of his or her mother.
In my experience, pregnant mothers often do not assess their own nutritional health or digestive ailments until they become pregnant.
More often pregnant women only seek nutritional guidance if they suffer from morning sickness, food aversions, gestational diabetes, hypertension or other ailments.
And, fathers too, often see their initial role as little more than 50% of the genetic material needed to produce their baby.
Few men understand or evaluate their nutritional health prior to contributing this genetic material with their partner.
So, it is quite understandable that baby’s future digestive health, nutritional status and growth and development patterns would not be thought of in advance either.
The Difference Between Food Allergies and Intolerances
The body makes different immunoglobulins to combat different antigens. In blood tests, immunoglobulins are often measured together.
That way, they can give doctors important information about immune system functioning, especially relating to infection or autoimmune disease.
Generally, there are 3 types of food allergy and intolerance conditions, as determined by elevated levels of different immunoglobulins: IgE, IgG, and IgA.
A true allergy is almost always mediated through IgE, which produces severe, systemic and usually immediate reactions from ingesting minute quantities of the offending food.
Symptoms almost always occur shortly after eating and produce mild to severe anaphylaxis.
The percentage of the general population with IgE mediated food allergies is around 4%.
Food intolerances (sometimes called “sensitivities”) are mediated through IgG (and sometimes IgA), and are much more pervasive and cause milder symptoms.
Chronic, widespread complaints are commonly associated with food intolerances.
Eczema, digestive disturbances, headaches, and sinusitis have all been associated with food intolerances.
Food intolerance is usually defined by an inflammatory process that has taken hold in the digestive system or elsewhere in the body.
A list of common food intolerance symptoms:
- Gastrointestinal (stomach and digestive tract - bloating, diarrhoea, irritable bowel syndrome, colitis etc.) and also the term “leaky gut” used to describe a person with multiple food or chemical sensitivities, autoimmune illnesses or chronic infections due to inflammation
- Respiratory (lungs and breathing - chronic cough, asthma, sinusitis, bronchitis etc.)
- Dermatological (skin conditions - eczema, psoriasis etc.)
- Neurological (nervous system - chronic headache, neuropathies)
- Mental - (behavioral, memory, mood issues, depression)
- Musculo-skeletal (muscle and bone disorders - stiff joints, arthritis, gout)
- Reproductive (hormonal and fertility issues - inability to conceive, miscarriage)
- Immune system (allergies and frequent infections)
- Malabsorption (nutrient deficiencies - (iron) anemia, (minerals like calcium, magnesium, phosphorus) osteoporosis, (b vitamins) neurological and hormone disorders...and…(low protein, minerals, etc.) FAILURE TO THRIVE.)
Good Bacteria to the Rescue
As I have already indicated, food intolerance may be genetically passed from generation to generation.
There is a deeper origin of food intolerance, which I like to introduce to this conversation.
The concept that the microbiome and our gut flora variety and stability influence the gut flora of our offspring.
I am talking about “good bugs.” Probiotics.
A February 2018 U.K. study found that mothers who took fish oil and probiotics during pregnancy reduced their child’s risk of food allergies and eczema.
I believe the positive outcome of the study is due in part to the anti-inflammatory action of the fish oil combined with the strain-specific beneficial bacteria.
Both regulates immune system over-activity in relation to food antigens.
In other words - the fish oil reduced food antigen-mediated (IgG) inflammatory processes. The probiotics down-regulated the immune system to not be so reactive to certain foods.
Either way, this is good news for moms, dads and babies.
When your child has been diagnosed with Failure to Thrive
First of all, each and every child is unique. There is no one set of perfect answers to solve FTT.
If you have been given a diagnosis of Failure to Thrive, I encourage you to speak to your pediatrician about the possible causes of the growth and developmental delays or difficulties.
Secondly, I encourage you to consider if there are any digestive, immune system or food-related symptoms (no matter how infrequent or mild they may seem) which you have noticed for your child, or that your child has told you about.
Pay attention to their habits, their food choices, energy levels throughout the day and patterns of well and unwell.
Monitor them to see if there are any signs that your child might have general inflammatory symptoms or symptoms of food intolerance.
Relating to your child's food intake.
Is your child eating well? Do they have a good appetite? Do they enjoy food? Are mealtimes difficult? Is your child “picky”? Does your child only gravitate towards certain foods (bland, sweet, starchy, etc.)?
Also consider, does your child have:
- Frequent tummy aches and general feeling unwell - especially after eating
- Gas, bloating, belching, reflux, colic, food regurgitation, trouble swallowing or
- Chronic respiratory infections, coughs that do not go away, post-nasal drip, ear infections or sinus infections
- Difficulty with bowel movements - either constipation or overly loose stools
- Skin rashes, hives, eczema or sensitive skin (to lotions, sunscreen, sunshine, bug bites, etc.)
- Unexplained behavioral concerns such as excessive tantrums, moodiness, crying spells or periods of being withdrawn
- Sleep disturbances, nightmares/night terrors, night waking and/or walking, waking up feeling unrefreshed even after 9-12 hours in bed
- Headaches, migraines
- Muscle aches and pains, joint pains, bone fractures, restless legs or “growing” pains
- Delayed puberty, absence of menstruation (in teenage females after age 16), short stature, muscle loss/difficulty building mass (in teenage males after age 14), significant weight loss
If you answered yes to 3 or more of the questions above, there is a possibility that your child’s FTT is related to inflammation due to food intolerances.
Please also keep in mind, many children with food intolerances are actually 100% symptom-free. I see that situation all the time.
Eliminate food that causes discomfort to your child
At home, start with keeping track of the foods your child is ingesting. If there are any resultant symptoms or side effects from certain foods, record it down as well.
- Keep a food journal with or for your child to see if you notice any occurrences of discomfort.
- Eliminate any obvious offending foods from your child’s food plan for a minimum of 30 days.
- Food elimination is easiest to do if you can record and eliminate foods while you are eating mostly at home. When you have home cooked meals, you can control the ingredients. It helps you to pay attention to symptoms and be consistent with recording the details.
- Reintroduction of foods to assess and understand the body’s reaction after a period of rest away from that food.
- Incorporate gentle, kid-friendly digestive support aids to reduce symptoms. Example, ginger and peppermint tea to soothe belly pains, deglycerized licorice chewable tablets to combat indigestion, bitters (available in health food stores) to support complete digestion and probiotics for assisting in regular and easy to pass stools.
Self-management of possible food intolerance symptoms is a great first step.
Why Failure to Thrive should not be left untreated
The thing is, FTT left untreated can lead to more serious health problems and diseases later in life.
Unaddressed digestive illness, food intolerance and wonky immune system functioning can over time turn in to autoimmune disease.
Autoimmune disease is one of the broadest and fastest growing categories of illnesses in our country.
In many cases, people affected are given a diagnosis of more than one of these diseases in their lifetime.
Some 50 million people are affected with autoimmune illnesses.
Autoimmune illnesses encompass Hashimoto's thyroiditis, Lupus, Alopecia, Celiac disease, type-2 Diabetes and many, many more.
And, finally, failure to thrive that progresses from childhood into adulthood also means malabsorption, malnutrition and deficiency diseases.
And this has the potential to affect nearly every system of the body (brain, eyes, nervous system, reproductive health, bones, teeth, etc.!).
BUT this is preventable earlier in life with basic nutrition intervention.
The key is knowing your body, what foods you tolerate best, how to help heal your digestive system and how to maintain your good health.
Next Step: Get Help For Your Child
If you have been working on this for your child for a while now, and too many foods appear to be offenders, or the removal and reintroduction of foods is too complicated, you may need to get professional help.
How a holistic nutritionist can support a child with Failure to Thrive:
- Order non-invasive testing to ascertain IgG-mediated food antigen/intolerances
- Establish a timeline for removal and reintroduction of offending foods
- Review of food journal to find patterns of physical and behavioral connections to offending foods
- Suggest proper supplementation to reduce inflammation from foods. This also helps to repopulate the digestive tract with the friendly bacteria (probiotics) necessary for calming the immune system
- Ensure proper nutrient acquisition takes place easily and naturally for your child’s normal growth and development through meal planning, strategies, grocery shopping, label reading, etc.
- Serve as a guide and supportive partner in a sometimes daunting and nerve-wracking journey with your child to uncover their root cause of Failure to Thrive.