Organic versus Nonorganic Failure to Thrive

Organic failure to thrive is that caused by the harmful effects on growth of organic disease. Growth failure can be an extremely sensitive marker for unsuspected systemic disease, revealing illness long before it would normally be detected. Likewise, the progress of therapy is often dramatically mirrored by improvement in growth. Any significant illness in an infant or young child can cause growth failure. Thus growth failure alone alerts the physician to search for possible medical causes. Nevertheless, the search for organic disease in young children with an initial diagnosis of failure to thrive most often finds no physical (organic) condition to explain the growth failure; the failure is therefore termed nonorganic.

The modern understanding of this disorder views it as a fundamental failure of maternal-infant attachment. In fact, it is referred to in psychiatric literature as feeding disorder of attachment, as well as maternal deprivation, deprivation dwarfism, and psychosocial deprivation. Nonorganic failure to thrive reflects a failed relationship between a mother and her infant during the first year of life. Its chief characteristic is a lack of engagement or bonding between mother and infant in the daily routine of care, most dramatically with respect to feeding.

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