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A Multifaceted Intervention for Infants With Failure to Thrive-Reply

Patrick Casey, MD; Kelly J. Kellener, MD, MPH; Robert H. Bradley, PhD; Kimberlea W. Kellogg, MBA; Russell S. Kirby, PhD, MS; Leanne Whiteside, MS
Arch Pediatr Adolesc Med. 1995;149(9):1041. doi:10.1001/archpedi.1995.02170220105021.
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Drs Karp and Wadoski do not appear to dispute the major findings of our recent publication; rather, they attempt to explain why the Infant Health and Development Program intervention failed to decrease the incidence of FTT in this low-birth-weight (LBW) population.1 This occurred, they believe, because most of the subjects did not in fact have FTT and also because nutrition was not a major factor in influencing growth in these infants.

Regarding the diagnosis of FTT in our subjects, Drs Karp and Wadoski are unhappy with our case definition. Because of the absence of a uniformly accepted definition of FTT in the clinical and research literature, we developed a case definition that we believed was cautious in requiring (1) clinician identification, (2) documentation of low weight for gender and gestation-corrected age on more than one occasion, and (3) less than expected growth velocity. We stand by this


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