<p>The reason for failure to thrive other than insufficient nutrition, can be suppressed growth hormone secretion due to emotional neglect. In the following example, both the emotional neglect and insufficient nutrition were combined, though:</p>

<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/10572896" rel="nofollow noreferrer">Psychosocially stunted growth masked as growth hormone deficiency, (Klinische Pediatrie, 1999)</a>:</p>

<blockquote>
  <p>Short stature is a common reason for presenting a child to the
  pediatrician. <strong>Emotional deprivation may cause short stature and may
  simulate growth hormone deficiency.</strong> Diagnosis of emotional
  deprivation as the cause of growth retardation is difficult and
  misdiagnosed frequently despite of suspicious clinical signs. We
  report on 2 patients with growth retardation because of emotional
  deprivation. At the age of 5 years both children had a severe growth
  hormone deficiency. They received therapy with growth hormone and
  showed an increase of growth velocity to > or = 8 cm in the first year
  of treatment. But in the third year of treatment both patients showed
  a diminished response to the growth hormone therapy. During the period
  of observation the features of emotional deprivation became obvious
  through the extreme behavioural abnormalities. Both children showed
  disturbances in their social behaviour, and striking disorders
  concerning eating and digestion. The families of these children had
  severe social problems; alcoholism, low income and rejection of the
  child were risk factors. <strong>Removal from the current environment led to
  a characteristic increase of the growth velocity. Growth hormone
  deficiency was spontaneously reversible, so that treatment with growth
  hormone was terminated.</strong> The social environment and the psychical
  prosperity are essential growth factors in childhood and adolescence.
  The common features and risk factors of emotional deprivation are
  described. <strong>Spontaneous catch-up growth after removal from the
  current environment distinguishes this form of short stature from the
  other organic growth disorders.</strong></p>
</blockquote>

<p><a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/failure-to-thrive" rel="nofollow noreferrer">Hopkins Medicine</a> says that:</p>

<blockquote>
  <p>Other factors that may lead to failure to thrive:</p>
  
  <ul>
  <li>Emotional deprivation as a result of parental withdrawal, rejection or
  hostility</li>
  </ul>
</blockquote>

<p>and </p>

<blockquote>
  <p>Problems with the endocrine system, such as thyroid hormone
  deficiency, growth hormone deficiency or other hormone deficiencies...</p>
</blockquote>

<p>...some of which might be triggered by emotional neglect despite proper nutrition:</p>

<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/8680203" rel="nofollow noreferrer">Failure to grow: lack of food or lack of love? (Professional Care of Mother and Child, 1994)</a>:</p>

<blockquote>
  <p>One of the most important criteria for good health in childhood is
  normal growth. Taking regular accurate measurements of length and
  plotting them on a centile chart is essential to spot early signs of
  growth disorders. Be alert for a "zig-zag" pattern on the chart: it
  could indicate <strong>psychosocial dwarfism</strong> (see opposite). Length is
  more important than weight for identifying growth disorders. <strong>Lack of
  love, or an adverse emotional or social environment, can cause growth
  failure even in a child who is eating enough.</strong> Such children have a
  condition called psychosocial dwarfism, which is due to
  <strong>hypopituitarism (too little growth hormone secretion from the pituitary gland). This condition does not respond to growth hormone
  treatment. Once the child is placed in an alternative environment, eg
  a good foster home, the hypopituitarism is reversed and rapid
  "catch-up" growth takes place.</strong> It often emerges that such children
  have been physically, emotionally or sexually abused.</p>
</blockquote>

<p>I'm not aware of any case in which psychological reasons alone in a properly fed child would result in death associated with failure to thrive. When it comes to failure to thrive in certain orphanges, I would not ascribe it solely to psychological reasons... </p>

CC BY-SA 4.0
2020-01-22T13:41:36.397Z
2020-01-22T14:32:07.653Z
2020-01-22T14:32:07.653Z
Jan
<p>This question, whilst to a degree can be seen as &quot;common sense&quot; in some respects, has puzzled me in other ways.</p>
<p>Looking at the situations where <em>Failure to Thrive</em> (FTT) can cause death, even the <a href="https://en.wikipedia.org/wiki/Failure_to_thrive" rel="nofollow noreferrer">Wikipedia article</a> for it mentions mental issues as an endogenous cause, while there can also be one or more of both endogenous and exogenous causes.</p>
<p>I am intrigued by the mental issues for FTT deaths. What kind of mental issues, other than the obvious such as anorexia, can cause death due to FTT.</p>
<p>I am particularly interested in the cases where babies die due to FTT even though they have been fed, such as in orphanages.</p>
<p>Looking at a situation in Romania, I remember news reports during the dictatorship of Nicolae Ceaușescu, where there were large numbers of young children under 5 dying in orphanages due to FTT. I cannot find any reference to this online, however there is an APA report (<a href="https://www.apa.org/monitor/2014/06/neglect" rel="nofollow noreferrer">Weir, 2014</a>) which mentions institutional neglect causing developmental delays.</p>
<p>As well as developmental delays, can  neglect through lack of emotional care be the cause of death through FTT? If so, how does the death occur even if nutritional needs are met?</p>
<h2>References</h2>
<p>Weir, K. (2014). The lasting impact of neglect. <em>Monitor on Psychology 45</em>(6), 36. Retrieved from: <a href="https://www.apa.org/monitor/2014/06/neglect" rel="nofollow noreferrer">https://www.apa.org/monitor/2014/06/neglect</a></p>

CC BY-SA 4.0
2020-01-22T14:10:11.320Z
Is it only me or the apa.org link does not open?
Jan
CC BY-SA 4.0
2020-01-22T16:36:10.967Z
@Jan works for me.
Steven Jeuris
CC BY-SA 4.0
2020-01-30T20:42:02.600Z
I don't know much about this, but looking at the wiki article the only place where I see mentioned fatality (or death) is in a paragraph about [Refeeding syndrome](https://en.wikipedia.org/wiki/Refeeding_syndrome).
got trolled too much this week
<social-psychology><developmental-psychology><brain-development><cognitive-development>
Death caused by "Failure to Thrive" (FTT)
Chris Rogers
# Death caused by "Failure to Thrive" (FTT)

(Asked by: username_0 on 2020-01-22)

This question, whilst to a degree can be seen as "common sense" in some respects, has puzzled me in other ways.

Looking at the situations where *Failure to Thrive* (FTT) can cause death, even the [Wikipedia article](https://en.wikipedia.org/wiki/Failure_to_thrive) for it mentions mental issues as an endogenous cause, while there can also be one or more of both endogenous and exogenous causes.

I am intrigued by the mental issues for FTT deaths. What kind of mental issues, other than the obvious such as anorexia, can cause death due to FTT.

I am particularly interested in the cases where babies die due to FTT even though they have been fed, such as in orphanages.

Looking at a situation in Romania, I remember news reports during the dictatorship of Nicolae Ceaușescu, where there were large numbers of young children under 5 dying in orphanages due to FTT. I cannot find any reference to this online, however there is an APA report ([Weir, 2014](https://www.apa.org/monitor/2014/06/neglect)) which mentions institutional neglect causing developmental delays.

As well as developmental delays, can neglect through lack of emotional care be the cause of death through FTT? If so, how does the death occur even if nutritional needs are met?

## References

Weir, K. (2014). The lasting impact of neglect. *Monitor on Psychology 45*(6), 36. Retrieved from: <https://www.apa.org/monitor/2014/06/neglect>

**Tags:** social-psychology, developmental-psychology, brain-development, cognitive-development

> **Comments:**
> **username_1**: Is it only me or the apa.org link does not open?  
> **username_2**: @username_1 works for me.  
> **username_3**: I don't know much about this, but looking at the wiki article the only place where I see mentioned fatality (or death) is in a paragraph about [Refeeding syndrome](https://en.wikipedia.org/wiki/Refeeding_syndrome).  

---

## 1 answers

### Answer by username_1 on 2020-01-22. Score: 4 | Accepted answer

The reason for failure to thrive other than insufficient nutrition, can be suppressed growth hormone secretion due to emotional neglect. In the following example, both the emotional neglect and insufficient nutrition were combined, though:

[Psychosocially stunted growth masked as growth hormone deficiency, (Klinische Pediatrie, 1999)](https://www.ncbi.nlm.nih.gov/pubmed/10572896):

> Short stature is a common reason for presenting a child to the
> pediatrician. **Emotional deprivation may cause short stature and may
> simulate growth hormone deficiency.** Diagnosis of emotional
> deprivation as the cause of growth retardation is difficult and
> misdiagnosed frequently despite of suspicious clinical signs. We
> report on 2 patients with growth retardation because of emotional
> deprivation. At the age of 5 years both children had a severe growth
> hormone deficiency. They received therapy with growth hormone and
> showed an increase of growth velocity to > or = 8 cm in the first year
> of treatment. But in the third year of treatment both patients showed
> a diminished response to the growth hormone therapy. During the period
> of observation the features of emotional deprivation became obvious
> through the extreme behavioural abnormalities. Both children showed
> disturbances in their social behaviour, and striking disorders
> concerning eating and digestion. The families of these children had
> severe social problems; alcoholism, low income and rejection of the
> child were risk factors. **Removal from the current environment led to
> a characteristic increase of the growth velocity. Growth hormone
> deficiency was spontaneously reversible, so that treatment with growth
> hormone was terminated.** The social environment and the psychical
> prosperity are essential growth factors in childhood and adolescence.
> The common features and risk factors of emotional deprivation are
> described. **Spontaneous catch-up growth after removal from the
> current environment distinguishes this form of short stature from the
> other organic growth disorders.**

[Hopkins Medicine](https://www.hopkinsmedicine.org/health/conditions-and-diseases/failure-to-thrive) says that:

> Other factors that may lead to failure to thrive:
>
> * Emotional deprivation as a result of parental withdrawal, rejection or
>   hostility

and

> Problems with the endocrine system, such as thyroid hormone
> deficiency, growth hormone deficiency or other hormone deficiencies...

...some of which might be triggered by emotional neglect despite proper nutrition:

[Failure to grow: lack of food or lack of love? (Professional Care of Mother and Child, 1994)](https://www.ncbi.nlm.nih.gov/pubmed/8680203):

> One of the most important criteria for good health in childhood is
> normal growth. Taking regular accurate measurements of length and
> plotting them on a centile chart is essential to spot early signs of
> growth disorders. Be alert for a "zig-zag" pattern on the chart: it
> could indicate **psychosocial dwarfism** (see opposite). Length is
> more important than weight for identifying growth disorders. **Lack of
> love, or an adverse emotional or social environment, can cause growth
> failure even in a child who is eating enough.** Such children have a
> condition called psychosocial dwarfism, which is due to
> **hypopituitarism (too little growth hormone secretion from the pituitary gland). This condition does not respond to growth hormone
> treatment. Once the child is placed in an alternative environment, eg
> a good foster home, the hypopituitarism is reversed and rapid
> "catch-up" growth takes place.** It often emerges that such children
> have been physically, emotionally or sexually abused.

I'm not aware of any case in which psychological reasons alone in a properly fed child would result in death associated with failure to thrive. When it comes to failure to thrive in certain orphanges, I would not ascribe it solely to psychological reasons...


---

