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Doody's Review ServiceReviewer: Jeffery A. Wright, MD (University of Washington School of Medicine)
Description: An outstanding group of experts in the field of pediatric under nutrition has been assembled. This comprehensive review looks at the complex disorder from the viewpoints of the best minds in the various disciplines involved.
Purpose: The purpose is to provide a comprehensive resource for those who work with children who have growth failure. The hope is to help them do their work better and move the field forward.
Audience: It is written for physicians, nutritionists, nurse practitioners, early interventionists, public health personnel, home visitors, community health nurses, social workers, speech-language pathologists, occupational specialists, and policy makers.
Features: The introductory chapter discusses the confusion regarding the term "failure to thrive." Unfortunately, after making a compelling argument for abandoning the term, it is used in the title of this book and in each chapter. The book makes great progress towards recognizing the differences and similarities between malnutrition in children worldwide and understanding growth failure in industrialized countries; however, the gap is not completely bridged. This book remains a step in a process of reconciliation. Sorting the various factors that potentially contribute to growth failure in a child is intellectually challenging for seasoned pediatricians. This book represents the state-of-the-art understanding of these various factors and it covers the gamut from the parent-child relationship to medical, family, and societal disorders. One can not help but feel somewhat overwhelmed by the complexity of this condition, but each chapter is short enough to break it into digestible portions. The medical evaluation is nicely outlined, with due restraint urged to avoid overtesting and unnecessary hospitalization. There is good attention paid to all aspects of this complex condition including cross-cultural issues, psychological and medical factors, and issues related to advocacy, managed care, and classification. The complexity of this condition supports the evaluation by specialists in different fields. Outcome of treatment for this condition is better when a transdisciplinary approach is used. A short, poignant, chapter defines the difficulties in running one of these teams. It also highlights the value of home-based intervention in treatment. The book has the general appearance of a grade school textbook. It is a good size to hold and read. The color of the pages and print font are pleasing. There is no use of color photos or text to allure the reader. The photos appear to be grayscale copies of color photos, so clarity and impact is lost. Some of the pages were not cut so they did not separate. The main problem with the book is its organization. Each chapter seems isolated and sometimes duplicates the content in other chapters. The wonderful chapters on "The Feeding Relationship" and "Behavior Problems in Feeding, Individual, Family, and Cultural Influences," are separated from the section on families, including chapters on "Cultural Issues in Provider-Parent Relationships," "Family Routines and the Feeding Process," "Psychological Issues and Infant-Parent Psychotherapy," and "Toward Understanding the Role of Attachment in Malnutrition." There is admixture of prevention, assessment, and treatment in the each chapter. The complexity of this field is highlighted, and a transdisciplinary approach is supported, but the reader must digest the entire book to gain the wisdom needed to approach this condition. It would have helped to have the sections on prevention, assessment, and management with more interactions among the participating contributors (similar to the functional transdisciplinary team endorsed). About 20 percent of the book is devoted to useful and under-recognized resources which are contained in the appendixes. These provide a great reference resource for the generalist.
Assessment: The work builds on, adds to, and possibly supplants the prior works, like Accardo's Failure to Thrive in Infancy and Early Childhood (1982), and Drotar's New Directions in Failure to Thrive: Implications for Research and Practice (1986). Many of the authors in the second book present updated information in this current work. I recommend this book as an essential component of the core library for all general pediatricians. I encourage them to read it completely. It should be available, as a reference, for all other professionals who deal with infants and young children.