{
  "schema_version": 1,
  "kind": "condition",
  "id": "failure-to-thrive-infant",
  "name": "Failure to Thrive (Faltering Growth in Infants)",
  "category": "chronic",
  "sources": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (ferrous fumarate monograph) · NICE Guideline NG75: Faltering growth 2017 · WHO Child Growth Standards Guidance",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (ferrous fumarate monograph) · Failure to Thrive - disease-level clinical article (failure-to-thrive-infant-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 727,
      "generic": "Multivitamin + Iron",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.liquid",
      "strength_mg": null,
      "adult_dose": "Not applicable - pediatric entry",
      "adult_duration": "3-6 months under growth monitoring",
      "dose_source": "Egyptian National Drug Formulary - Blood Disorder Medications 2025 (ferrous fumarate monograph)",
      "rationale": "Iron replacement where the iron panel shows deficiency, the commonest micronutrient deficiency at this age, while the calorie deficit and any organic cause are investigated. The iron figure is the Egyptian formulary's; no guideline states a dose for the multivitamin half of a combination syrup.",
      "cautions": [
        "PRIMARY CARE ROLE: Perform detailed feeding history, observe feeding session, calculate caloric density.",
        "The red flags requiring urgent pediatric referral are organomegaly, dysmorphic features, developmental regression, severe anemia, and abnormal urinalysis.",
        "Do not rely solely on vitamin supplements without addressing caloric deficit and psychosocial factors.",
        "Dose a combination multivitamin+iron syrup by the elemental iron its carton states, not by the volume above - the figure here is the formulary's ferrous fumarate syrup. No guideline doses the vitamin component for faltering growth; give it per its own product label."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Only where iron deficiency is identified. Egyptian formulary paediatric dose: ferrous fumarate 140 mg/5 mL syrup 0.5 mL/kg/day in 2-3 divided doses, maximum 20 mL a day - that is 4.5 mg/kg/day of elemental iron, ceiling 180 mg. Premature infants up to 3 kg: 0.5 mL a day.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "FERNISAL 120 ML SYR",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ORGANIX > SALUS PHARMACEUTICAL",
          "price_egp": 75.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "failure-to-thrive-infant"
    },
    {
      "id": 728,
      "generic": "Referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": null,
      "adult_duration": null,
      "dose_source": "Failure to Thrive - disease-level clinical article (failure-to-thrive-infant-clinical.txt)",
      "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.",
      "cautions": [
        "RED FLAG - The hospitalization criteria are severe malnutrition, dehydration, suspected abuse or neglect, and failed outpatient management."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": null,
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "failure-to-thrive-infant"
    }
  ]
}