A multifaceted intervention for infants with failure to thrive. A prospective study

Arch Pediatr Adolesc Med. 1994 Oct;148(10):1071-7. doi: 10.1001/archpedi.1994.02170100069014.


Objective: To determine whether a multifaceted intervention decreased the incidence of failure to thrive (FTT) in a group of preterm infants with low birth weights and improved the 3-year intelligence, health, growth, and behavior status of the children with FTT.

Design: Three-year, prospective, randomized, clinical trial.

Setting: Eight large university hospital sites throughout the United States.

Sample: Nine hundred fourteen preterm infants with low birth weights who were born at the sites and met study criteria.

Intervention: Home visits weekly during the first year of life and biweekly thereafter until the age of 3 years to provide family support and implement two curricula; and attendance at a child development center from 12 months until 3 years of age, 5 days a week, to deliver an early childhood educational intervention.

Results: The incidence of FTT did not differ between the treatment and control groups (20% vs 22%). Overall, children with FTT in the treatment group were not different from children with FTT in the follow-up group on any of the outcome variables. However, after controlling for other factors, treatment group membership significantly contributed to the prediction model of 36-month IQ (P = .005) for the children with FTT. In addition, children with FTT in the intervention group with higher compliance demonstrated higher 3-year IQ and better behavior scores than the children with FTT in the low-compliance group.

Conclusions: The intervention did not change the incidence of FTT or the 3-year outcomes in this low-birth-weight, preterm cohort. After controlling for multiple independent variables, marked effects on 3-year IQ were noted. In addition, these beneficial effects were most pronounced in families that were most complaint with the intervention.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child Behavior
  • Child, Preschool
  • Early Intervention, Educational*
  • Failure to Thrive / prevention & control
  • Failure to Thrive / therapy*
  • Humans
  • Infant, Low Birth Weight* / growth & development
  • Infant, Low Birth Weight* / psychology
  • Infant, Newborn
  • Infant, Premature / growth & development
  • Infant, Premature / psychology
  • Intelligence
  • Patient Compliance
  • Prospective Studies
  • Treatment Outcome