Dr Jaffe has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/ investigative use of a commercial product/device.Objectives After completing this article, readers should be able to:1. Characterize the limitations of the classic dichotomy of "nonorganic" versus "organic" failure to thrive (FTT). Recognize that FTT is not a diagnosis but rather a physical sign of inadequate nutritionto support growth. 3. Know potential sequelae of FTT. 4. Understand how the diagnostic process must account for the multifactorial nature of FTT. 5. Describe a systems-based, multidisciplinary approach to treatment of FTT. 6. Discuss potential adverse effects of nutritional repletion of children who fail to thrive.

Compared 30 mothers whose children were hospitalized for failure-to-thrive (FTT) to a normative group on standardized measures of perceived stress and depression. Child and maternal medical and demographic data were also taken. Standardized development and feeding assessments were done. Descriptive statistics, correlational analyses, and t tests were used to describe and examine group differences. FTT children were perceived overall as more stressful, less adaptable, more inconsolable, and more unhappy than were healthy children. Child characteristics associated with higher maternal stress levels were higher birth weight, absence of organic disease or behavioral feeding problems, and higher IQ. Maternal self-report of depression, attachment to her child, sense of competence in parenting, social isolation, and relationship to spouse were not different from the normative sample.

No abstract