In Reply.—The purpose of our study was to determine if physicians could predict the etiology of failure to thrive. A corollary objective was to suggest that if the prediction was accurate it could be useful in maximizing the patient's therapeutic environment and also save money. We selected patients with admitting diagnoses of failure to thrive indicating that the admitting physician had already somewhat narrowed the diagnostic possibilities. Dr Oelberg makes the excellent point that many physicians do not recognize failure to thrive. His data indicated that many children's cases are being missed or "underdiagnosed" even prior to the point of being categorized.
We agree also that the term "failure to thrive" needs a more rigid definition and that it be clearly differentiated from other vague diagnoses such as "growth failure." We suggest that when the diagnosis of failure to thrive is made it should be followed by two terms