Failure to thrive and the risk of child abuse: a prospective population survey.
OBJECTIVE
To identify the relative importance of failure to thrive during infancy as a risk factor for later abuse or neglect.


METHODS
Whole population birth cohort (1 January to 31 December 1986) studied prospectively over a four year period.


METHODS
An inner city health district in London, England.


METHODS
2609 births, of whom 47 were identified as having non-organic failure to thrive by first birthday.


METHODS
Registration on Child Protection Register, or subject to investigation of suspected abuse or neglect without registration.


RESULTS
2.5% (64) of birth cohort had been placed on the Child Protection Register during the period 1986-1990, and a further 1.2% (32) had been a cause for concern. The relative risk attributable to non-organic failure to thrive was 4.3 (95% CI 1.65 to 11.94) and exceeded other measured risk factors, including birth weight < 2500 g, 1.96 (95% CI 1.01 to 3.82); gestation < 35 weeks, 3.26 (95% CI 1.32 to 3.75); ordinal position > or = 4, 1.53 (95% CI 0.72 to 3.23). A multiple logistic regression confirmed the independent contribution of non-organic failure to thrive to subsequent poor parenting warranting professional intervention.


CONCLUSIONS
Early postnatal non-organic failure to thrive is a risk factor for later serious parenting deficiencies, but previous research has overstated its importance. Within the community studied the nature of subsequent risk was (non-nutritional) neglect, rather than non-accidental injury. More than eight out of 10 cases do not give further cause for concern.
Behavioural Sciences Unit, Institute of Child Health, London, United Kingdom.
D H
DH
Skuse
D
D
Gill
S
S
Reilly
D
D
Wolke
M A
MA
Lynch
D000367:Age Factors; D002649:Child Abuse / Q000706:statistics & numerical data*; D005183:Failure to Thrive / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008131:London / Q000453:epidemiology; D015233:Models, Statistical; D010290:Parents; D011247:Pregnancy; D012307:Risk Factors; D012737:Sex Factors