Failure to Thrive

Key Question:
What is being done to help poverty-stricken families feed their malnourished children, in order to prevent them from developing "Failure to Thrive", a growth-retarding disease?

Lead: Boston doctor and program take innovative approach to help poor families feed and care for their malnourished children.

Brief Synopsis
Approximately 34.7 million people in the United States are threatened by hunger; a significant proportion of this malnourished population are children. Children who are poor and malnourished often suffer from what is known as "failure to thrive," or FTT. The effects of FTT are: shortened attention spans, increased risk of illness, persistent growth failure and emotional problems, and delayed cognitive development. Dr. Deborah Frank, director of the Growth and Development Program at Boston Medical Center, runs the "Failure to Thrive" (FTT) Clinic, which treats children diagnosed with this condition. Frank recognizes that malnutrition is not only a medical illness but also a socio-economic condition. At the Clinic, they step away from traditional medicinal cures and attempt to educate families as well as provide food for them. With an on-site therapeutic food pantry and donations from private support, up to 85% of the children treated at the Clinic have had their malnutrition resolved and have resumed normal growth.

Program
Grow Clinic for Children
Dr. Deborah Frank, Director
Boston Medical Center
818 Harrison Avenue-FGH-3
Boston, MA 02118
(617) 534-5251

Story Contacts
Dr. Deborah Frank Director
Grow Clinic Child Development Clinic c/o Gina DiGravio
Boston Medical Center
818 Harrison Avenue-FGH-3
Boston, MA 02118 (617) 638-8491

Superintendent Reginald Barnes
West Tallahatchie School District
P.O. Box 129 Webb
MS 38966
(601) 375-9291
Participant in the Free and Reduced Lunch Program

Ken Hecht Director
California Food Policy Advocates
116 New Montgomery Street , Suite 530
San Francisco, CA 94105
(415) 777-4422 ext.102
Expert on Nutritional Needs of Children and Families

Expert Contacts
Dr. J. Larry Brown Director
Center on Hunger, Poverty and Nutrition
Tufts University
11 Curtis Avenue
Medford, MA 02155
(617) 627-3956
Relevant area: Nutritional Effects on Children

Dr. David Levitsky, PhD
Cornell University
112 Savage Hall
Ithaca, NY 14853-6301
(607) 255-3263
Relevant area: Nutritional Development and Weight Regulation

Dr. Deborah Frank
Child Development Clinic C/o Gina DiGravio
Boston Medical Center
818 Harrison Avenue-FGH-3
Boston, MA 02118 (617) 638-8491
Relevant area: Child Development and Social Policy

Background
Failure to Thrive is a condition characterized by inadequate weight gain, based on the standard growth charts of the National Centers for Health Statistics. (Frank, D. A., Silva, M., and Needleman, R. (1993). Failure to Thrive: Mystery, myth, and method. Contemporary Pediatrics 114-133).

While specific activities may vary, most programs that address childhood malnutrition include some conventional activities such as the protection and promotion of breast-feeding, appropriate complementary feeding, nutrition education for behavioral change, nutritional support of the sick child and health referral. What often distinguishes successful programs is that communities are involved in identifying the problems and mobilizing action and resources for solving them. (U.S. News Online. (http://www.who.int/inf-fs/en/fact119.html).

A child who suffers infantile malnutrition and then receives enough nourishment in later years will still most likely suffer from impaired behavioral and cognitive functioning. Other disabilities involve motor-skill development, and reading and writing deficiencies. (O'Brien, J.C. (1991). Infantile malnutrition. Boston University Medicine 17-19. (http://www.thriveonline.com/health/Library/CAD/abstract14781.html).

According to doctors at Massachusetts General Hospital, breakfast does affect students' grade performance. In a study of more than 100 third to eighth graders, those who were given the chance to eat a free breakfast at school for four months experienced a greater increase in their math grades. (U.S. News Online. (http://www.usnews.com/usnews/issue/981109/9brea.htm).

A 1997 USDA study found that 34.7 million people in the U.S. are threatened by hunger and 12 million American households report limited or certain access to food. (http://www.usda.gov).

A U.S. News study shows that 75% of children who skip breakfast never catch up on daily requirements for calcium, and a third fall short on protein. (http://www.usnews.com/usnews/issue/981109/9brea.htm).

Child poverty is spreading fastest in the suburbs. Still, urban kids are most likely to be poor-40% in some cities. (National Center for Children in Poverty. In "The Poorest Among Us." (http://www.usnews.com/usnews/issue/23chil.htm).

Another USDA study found that the nation wastes more than 96 billion pounds of food each year. If one-third of this were to be rescued and distributed in America, there would be enough to feed 450,000 people a day for a year. (http://www.usda.gov).

An estimated 174 million under-five children in the developing world are malnourished as indicated by low weight for age, and 230 million are stunted. ("Child Malnutrition." WHO Information. Fact Sheet, Fact Sheet No. 119. http://ww.who.int/inf-fs/en/fact119.html)

The December 1997 "State of the World's Children" report showed how a lack of access to adequate amounts of vitamins, minerals, and food affects development. ("State of the World's Children" Report, 1997, UNICEF)

According to Superintendent Reginald Barnes of the West Tallahatchie School District, roughly 94% of students are qualified for the Free and Reduced Lunch Program; after three years, Barnes has noticed a higher attendance rate and a lower drop-out rate, along with improved test scores. (Barnes, Reginald. Personal interview. 8 Mar. 1999.)

Related Coverage Diamant, Anita. "Upfront: Failing to thrive." The Boston Globe Magazine. 5 Jun. 1994. A Carnegie Corporation report announced that as many as 3 million infants and toddlers in the U.S. are poor and ill-fed.

Hacker, David, Community Nutrition Coordinator, Hunger Action Coalition. "Food for Thought_Too Many Hungry Children." JumpStart Michigan. October 1997. (http://www.jumpstartmich.com/hunger.html). Discusses issues of food stamps and the celebration of the National School Lunch Program.

McNally, Thomas S. "Seven million children die of malnutrition each year, according to UNICEF report." United Method News Service. 18 Dec. 1997. (http://www.umc.org/umns/news97/dec/704.htm). Church's task force guides initiative on children and poverty.

Melton, Marissa. "Cereal+milk=better math grades." U.S. News. Online. 9 Nov. 1998. (http://www.usnews.com/usnews/issue/981109/9brea.htm). Science proves breakfast makes you smarter.

Saltus, Richard. "Bad diets hamper the poor." The Boston Globe. 3 May 1995. Underfeeding can cause learning, thinking and behavioral problems.

Whitman, David. "Revisiting American family life." U.S. News. Online. 1 Feb. 1999. (http://www.usnews.com/usnews/issue/990201/1fami.htm). Study suggests parents are influencing their children in positive ways, resulting in stronger family life.

Compiled by: Jeanette Park