ABSTRACT
Failure to thrive (FTT) is a common and serious problem of infancy that is believed to have multifactorial etiology, including biological, nutritional, and environmental contributors (see Fig. 3.1), and is associated with poor long-term developmental, growth, health, and socioemotional outcomes (Pollitt, 1987; Pollitt et al., 1996). FTT is a condition that is particularly interesting to those working in the fields of attachment and developmental psychopathology because of the hypothesized interplay between the individual, biological characteristics of the infant and the caregiving environment in determining the onset, perpetuation, and resolution of FTT. Over the past several decades, researchers have focused on an increasingly controversial question: Does FTT reflect a disturbed caregiver-infant relationship and suboptimal caregiving or does it reflect problems within the infant, independent of the caregiving environment? Despite the controversy and the consideration of factors within the infant, many researchers in the field of FTT have continued to focus primarily on the caregiver-infant relationship. The objectives of this chapter are to: (a) briefly review research documenting the epidemiology, definition, etiology, and outcome of FTT to highlight the nature and significance of this problem; (b) review empirical evidence supporting or challenging the long-held belief that FTT is associated with a problematic caregiver-infant relationship, specifically the attachment relationship; (c) review empirical evidence pertaining to the question of whether infants with FTT could be at risk for disorders of attachment; and (d) examine new data regarding the possible association between infant regulatory problems and FTT. As a problem of infancy that occurs within the broader context of the parent-infant relationship, understanding the risk and protective factors within the infant, the caregiver, and the relationship that are associated with FTT presents a particular challenge.
