A MULTIFACETED INTERVENTION FOR INFANTS WITH FAILURE-TO-THRIVE - A PROSPECTIVE-STUDY

Objective: To determine whether a multifaceted intervention decreased the incidence of failure to thrive (FTT) in a group of preterm infants with low birth weights and improved the 3-year intelligence, health, growth, and behavior status of the children with FTT. Design: Three-ye ar, prospective, randomized, clinical trial. Setting: Eight large univ ersity hospital sites throughout the United States. Sample: Nine hundr ed fourteen preterm infants with low birth weights who were born at th e sites and met study criteria. Intervention: Home visits weekly durin g the first year of life and biweekly thereafter until the age of 3 ye ars to provide family support and implement two curricula; and attenda nce at a child development center from 12 months until 3 years of age, 5 days a week, to deliver an-early childhood educational intervention . Results: The incidence of FTT did not differ between the treatment a nd control groups (20% vs 22%). Overall, children with FTT in the trea tment group were not different from children with 1;IT in the follow-u p group on any of the outcome variables. However, after controlling fo r other factors, treatment group membership significantly contributed to the prediction model of 36 month IQ (P = .005) for the children wit h FTT. In addition, children with FTT in the intervention group with h igher compliance demonstrated higher 3-year IQ and better behavior sco res than the children with FTT in the low compliance group. Conclusion s: The intervention did not change the incidence of FTT or the 3-year outcomes in this low-birthweight, preterm cohort. After controlling fo r multiple independent variables, marked effects on 3-year IQ were not ed. In addition, these beneficial effects were most pronounced in fami lies that were most compliant with the intervention.