All issues > Volume 47(6); 2004

Original Article

Korean J Pediatr. 2004;47(6):604-610. Published online June 15, 2004.

Clinical Outcomes of Infants with Failure to Gain Weight among Out-patients

Byoung Cheol BC Lee¹, Hae Rim HR Kim¹, Chan Lack CL Sohn², Sin S Kam³, Jin-Bok JB Hwang¹

¹Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
²Department of Pediatrics, Han-Young Pediatric Clinic, Daegu, Korea
³Department of Preventive Medicine, College of Medicine, KyungPook National University, Daegu, Korea

Correspondence Jin-Bok JB Hwang ,Email: pedgi@korea.com

Abstract

Purpose
: The three categories of failure to thrive are based on anthropometric measurements of weight, length, and head circumference for age. Type 1 is a failure to gain weight(FGW) due mainly to malnutrition. This study was performed to observe the clinical outcomes of infants with FGW, Type 1, among out-patients.
Methods
: Between October 2002 and July 2003, data from the clinical outcomes of 83 consecutive patients at a Pediatric FGW Out-patients Clinic, all under 2 years of age, with inadequate growth or loss of body weight, was reviewed. This study concentrated on the Type 1 anthropometric category, with emphasis on the organic causes. FGW was defined as a weight loss for over two weeks in infants under 2 years of age. We observed four cases of breast feeding associated also as cases of misconception of diarrhea.
Results
: Of the 87 cases, the eight most prevalent final diagnoses were gastrointestinal cow milk allergy(32.2%), breast feeding associated(16.1%), misconception of diarrhea(15.0%), lactose intolerance (15.0%), gastroesophageal reflux disease(GERD)(5.7%), laryngomalacia(3.4%), solid foods associated (1.1%), and other organic diseases(11.5%). The period from onset of symptom to diagnosis was 3.9?.3 months, with over three months observed in 49.4% of patients. Although the birth weights were within a 10-90 percentile range in all patients, the body weight on diagnosis was below the 3 percentile in 63.8% of patinets.
Conclusion
: The most prevalent causes of FGW were gastrointestinal cow milk allergy, breast feeding associated, and misconception of diarrhea. The delayed diagnosis of FGW of over three months was frequently observed, and induced serious inadequate growth.

Keywords :Failure to thrive, Anthropometry, Milk hypersensitivity, Infant