A COMMUNITY-BASED STUDY OF FAILURE-TO-THRIVE IN ISRAEL

Objective-To examine the characteristics of infants suffering from fai lure to thrive in a community based cohort in Israel and to ascertain the effect of failure to thrive on their cognitive development. Method s-By review of records maintained at maternal and child health clinics in Jerusalem and the town of Belt Shemesh, epidemiological data were obtained at age 15 months on a cohort of all babies born in 1991. For each case of failure to thrive, a matched control was selected from th e same maternal and child health clinic. At age 20 months, cognitive d evelopment was measured, and at 25 months a home visit was carried out to assess maternal psychiatric status by questionnaire, and the HOME assessment was performed to assess the home environment. Results-3.9% of infants were found to have fallen below the third centile in weight for at least three months during the first year of life. Infants with failure to thrive did not differ from the general population in terms of obstetric or neonatal complications, birth order, or parents' ethn ic origin, age, or years of education. The infants with failure to thr ive did have lower birthweights and marginally smaller head circumfere nces at birth. Developmental assessment at 20 months of age showed a D Q of 99.7 v 107.2 in the matched controls, with 11.5% having a DQ belo w 80, as opposed to only 4.6% of the controls. No differences were fou nd in maternal psychiatric problems as measured by a self report quest ionnaire. There were, however, significant differences in subscales of the HOME scale. Conclusions-(1) Infants who suffered from failure to thrive had some physiological predispositions that put them at risk; ( 2) failure to thrive may be an early marker of families providing subo ptimal developmental stimulation.