Failure to Thrive



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Failure to Thrive

Order Other Consults Per Historical Clues

Discharge to Home with close Follow-up Arranged

Ideal body weight?

Meets early discharge criteria*?

  1. Obtain UA, CBC. +/- CHEM20, Zinc, 25 OH Vit D, prealbumin, iron studies, B12, folate, stool guaiac if not done outpatient
  2. Order Daily Weights with Infant Scale, Strict I/Os with Stool Qualification
  3. Order Calorie Count x 3 days

Concern for refeeding syndrome?

  1. Bedside monitoring
  2. Send Refeeding Labs (Chem 20 initially Q8- 12hr)

Other consults needed?

Order Consults:

  1. Nutrition
  2. Social Work
  3. PT/OT/Speech/Lactation
  4. GI

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway please contact the Clinical Pathway Oversight Committee at CPOC@montefiore.org.

Disclaimer: Clinical pathways are intended as a resource to guide diagnosis, treatment and management in order to improve quality of care and promote better patient outcomes. They are based on available medical evidence at the time of development; the date on the pathway indicates the most recent update. Pathways are not intended to provide medical advice or consultation regarding the care of any individual patient, and should not replace or supersede a practitioner’s professional opinion or clinical judgment. Because medical knowledge is constantly evolving, and accepting the possibility of error, The Children’s Hospital at Montefiore does not warrant or represent that pathways are complete or accurate. Neither the Hospital nor the individuals involved in the development or publication of the pathways is responsible for results or outcomes related to their use.

Inclusion Criteria
  • Failure to Thrive
  • 0-12 months
Exclusion Criteria
  • Known Diagnosis that Explains FTT
  1. H&P with detailed feeding/social hx
  2. Plot outpatient and admissions weights on WHO growth curve

  1. Labs per H&P
  2. Order Daily Weights with Infant Scale and Strict I/Os

Order Consults:

  1. Nutrition
  2. Social Work
  3. Speech/lactation if concern for poor feeding
  4. PT/OT if concern for developmental delay

*Early Discharge Criteria:

  • No signs of dehydration or severe malnutrition
  • No infectious concerns
  • No concern for refeeding syndrome
  • Social concerns addressed
  • Communication with outpatient provider
  • FTT Discharge Packet Reviewed

Note: weight gain is not required for discharge

Discharge Home After:

  1. Patient demonstrates adequate fluid and caloric intake
  2. Cleared by Social Work and home VNS services arranged
  3. Discuss patient with PMD
  4. FTT Discharge Packet reviewed

Refeeding Syndrome Criteria:

Initiating NGT Feeds/TPN OR >10% weight loss in 2 months OR Prolonged inadequate intake




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