Prolonged Breast-feeding and Nonorganic Failure to Thrive

Sir.—Failure to thrive is defined as failure of somatic growth with height and/or weight below the third percentile of standard growth charts, weight for height below the fifth percentile, or deceleration of growth velocity leading to a fall of two major percentiles of weight or height. When a patient does not have an organic disorder that explains the growth failure, the patient is diagnosed as having nonorganic failure to thrive (NOFTT). The typical psychosocial and nutritional pattern reported in NOFTT patients includes evidence of chaotic family life, emotional deprivation, and inadequate nutrition. We describe a group of four patients who did not fit the usual NOFTT profile.

Patients and Methods.—Four children (age range, 13 to 19 months) were referred to the University of Colorado Growth and Parenting Clinic, Denver, because of poor eating and growth. All four children were from middle-class families in which the father was living in