Pediatrics, part 64: Gastrointestinal Disorders - Failure to Thrive and Colic


Cathy discusses failure to thrive (FTT) and colic. She discusses the risk factors, signs/symptoms, labs, diagnosis, treatment, and family teaching for failure to thrive. Cathy then discusses signs/symptoms, diagnosis, treatment, and family teaching for colic. At the end of the video, she provides a quick quiz to test your understanding of key points she made in the video.

  • 00:00 Introduction
  • 00:25 Failure to Thrive (FTT)
  • 2:24 Colic
  • 4:20 Quiz Time!

Full Transcript: Pediatrics, part 64: Gastrointestinal Disorders - Failure to Thrive and Colic

Hi, I'm Cathy with Level Up RN. In this video, I will be discussing failure to thrive as well as colic. And at the end of the video, I'm going to give you guys a little quiz to test your understanding of some of the key points I'll be covering. So definitely stay tuned for that. And if you have our Level Up RN pediatric nursing flashcards, go ahead and pull out your flashcards so you can follow along with me.

Failure to thrive is where we have inadequate weight gain in a pediatric patient. This may be due to insufficient calorie intake, insufficient calorie absorption, or excess calorie expenditure. So some key risk factors that may be present in a patient with failure to thrive include low socioeconomic status as well as increased psychosocial stress in the home, such as neglect or an impaired child caregiver relationship. Signs and symptoms of failure to thrive include a weight that is below the 5th percentile on the growth chart, as well as developmental delays and decreased levels of prealbumin with blood work. In terms of diagnosis, it is important to identify any underlying medical conditions that may be contributing to the child's growth delay. So if there is an underlying cause such as cystic fibrosis or hyperthyroidism, for example, then we would obviously want to address that.

In the absence of any underlying medical condition, the focus of treatment is really on increasing calorie intake and addressing any issues with feeding behaviors. Increasing calorie intake may include concentrating formula for infants and replacing whole milk with high-calorie milk drinks for toddlers. Severe cases of failure to thrive may require tube feedings or parenteral nutrition. In terms of family teaching, it's important for caretakers to understand their child's nutritional requirements and the importance of establishing regular mealtimes and routines. And then juice consumption as well as other empty calories should be limited.

Moving on to colic now. Colic is defined as inconsolable infant crying and screaming without an obvious cause. So signs and symptoms of colic include continual crying and screaming that is unrelieved by soothing. The infant will often appear red-faced with their legs drawn up. So in terms of diagnosis of colic, it's important to rule out any underlying condition that may be causing the infant's symptoms, such as an infection. In most cases, however, an underlying cause for inconsolable crying is not found. So diagnosis of colic is based on the rule of threes. So episodes lasting more than three hours per day, more than three days a week, and for over three weeks. In addition, symptoms usually start around three weeks of age.

Treatment of colic is supportive and may include swaddling, massage, and providing a quiet, dark environment for the infant. There is also some evidence to suggest that in breastfed infants, probiotics and a strict maternal hypoallergenic diet may help reduce symptoms. Colic is obviously very difficult for parents to deal with. And it's important to reassure families that colic usually self-resolves by four months of age. It is also important to teach coping strategies to prevent injury to the infant. So caregivers should never shake a baby, which can lead to brain damage and death. If needed, the caretaker should be advised to lay the crying infant safely in their crib and walk away in order to prevent harming the infant.

All right. It's quiz time, and I've got three questions for you.

Question number one, with failure to thrive, the child's weight is below blank percent on the growth chart.

The answer is 5.

Question number two. Colic is diagnosed when crying episodes last more than blank hours a day, over blank days a week, and for more than blank weeks?

The answer is three, three, and three based on the rule of threes that we talked about earlier.

Question number three, if a caretaker is at risk for harming a colicky baby, what should they do instead?

The answer is lay the crying infant safely in the crib and walk away.

All right. That is it for this video.

I hope you found it to be helpful. Take care and good luck with studying.

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