Failure to Thrive

Studies in developing countries have shown that poor nutrition in early childhood leads to problems in cognitive functioning. Attention, self-regulatory skills for self-control, organizational skills, and performance on tests of cognitive functions and academic skills all appear to be vulnerable to the effects of malnutrition. The link between early, severe malnutrition and long-term deficits in emotional and cognitive development appears to extend into adolescence (Galler and Ramsey 1989). Research from industrialized countries where milder undernutrition is more typical suggests that it places young children at risk for developmental delays in all areas of development. At the time of the undernutrition, babies and toddlers typically score lower than well-nourished counterparts on tests of development, may have more behavioral feeding problems, are more likely to be insecurely attached to their mothers, and may show altered social responsiveness and irritability (Benoit 2000). Long-term effects of early failure to thrive have not been extensively studied, and the findings thus far are inconsistent. Some studies show little difference in cognitive and academic functioning between children with prior failure to thrive and well-nourished comparison children, whereas others indicate continued school-related difficulties and problems with behavior and personality development. It is important, in looking toward a child's future, to recognize that many other factors besides nutrition influence development (Shonkoff and Phillips 2000).

Undernutrition can limit long-term growth, which is why middle-aged and elderly people from developing countries are often short. In the United States, children from families below the federal poverty level are one to two centimeters shorter than children from families above it. Stunted children are likely to become stunted adults (Institute of Medicine 1996). Undernutrition can weaken the body's defense against infection; conversely, infection can impair nutrition. These effects are especially serious in developing countries, but in developed countries they are also important with certain chronic illnesses, such as cystic fibrosis and acquired immunodeficiency syndrome (AIDS).