A 6-month-old infant has developmental delays, his weight falls below the 5th percentile when plotted on a growth chart. A diagnosis of failure to thrive is made. What behaviours might indicate the possibility of maternal deprivation?

1. A

   Responsive to touch, wants to be held

2. B

   Uncomforted by touch, refuses bottle

3. C

   Maintains eye-to-eye contact

4. D

   Finicky eater, easily pacified, cuddly

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

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• Infants experiencing maternal deprivation often exhibit signs of reactive attachment disorder, including withdrawal and apathy.
• A key feature is a lack of social responsiveness, such as not being comforted by touch and showing little interest in the environment or caregivers.
• Feeding difficulties, including refusal of the bottle or breast, are common in nonorganic FTT and can be a direct result of a disturbed caregiver-infant interaction.
• These behaviors contrast sharply with those of a securely attached infant who seeks and responds positively to comfort and feeding.

Why Other Options Were Wrong

• Option A: This describes the behavior of a securely attached infant who trusts their caregiver and seeks comfort.
• Option C: Maintaining eye contact is a positive sign of social engagement and a key part of healthy infant development.
• Option D: While being a 'finicky eater' can be a concern, being 'easily pacified' and 'cuddly' are strong indicators of a secure attachment, making maternal deprivation unlikely.

Related Visual

• Visual 1: Comparison Chart - A side-by-side chart illustrating the behavioral differences between a securely attached infant and an infant at risk for maternal deprivation, covering responses to touch, feeding, eye contact, and general affect.
• Visual 2: Growth Chart - An example of a WHO growth chart showing a weight curve that has fallen from a higher percentile down below the 5th percentile, visually representing failure to thrive.

Clinical Relevance

• Nursing practice connection: Use the key finding related to The question tests the ability to identify behavioral signs of maternal deprivation in an infant diagnosed with nonorganic failure to thrive (FTT) to guide bedside assessment, documentation, and the next nursing action.
• Nurses are on the front line for identifying nonorganic FTT. Careful observation of feeding interactions and the infant's response to the caregiver is a critical assessment skill.
• Early identification and intervention are crucial, as prolonged deprivation can lead to long-term cognitive and emotional deficits.
• Management requires a multidisciplinary team, including social work, nutritionists, and mental health professionals, to support both the infant and the family.

How to Approach the Question

• First, identify the key concepts in the question: a 6-month-old infant with a diagnosis of 'failure to thrive' (FTT) and the need to identify signs of 'maternal deprivation'.
• Recall that FTT can be organic (caused by a medical condition) or nonorganic (psychosocial, like maternal deprivation). The question points towards the latter.
• Think about the typical behaviors of a healthy, securely attached infant versus an infant experiencing neglect or deprivation.
• A healthy infant seeks comfort, engages socially (eye contact, smiling), and generally feeds well. A deprived infant may be withdrawn, apathetic, avoidant, and have feeding problems.
• Evaluate each option: 'Responsive to touch' and 'maintains eye contact' are positive signs. 'Cuddly' and 'easily pacified' are also positive signs of attachment.
• The option 'Uncomforted by touch, refuses bottle' describes negative, withdrawn behaviors that directly align with the clinical picture of maternal deprivation and nonorganic FTT.

Concept Tested & Keywords

• Concept Tested: The question tests the ability to identify behavioral signs of maternal deprivation in an infant diagnosed with nonorganic failure to thrive (FTT).
• Stem keywords: 6-month-old infant, developmental delays, failure to thrive, maternal deprivation
• Lead-in keywords: behaviours might indicate
• Clinical cues: Weight below the 5th percentile is a key diagnostic criterion for FTT.
• Clinical cues: Developmental delays often accompany FTT, especially when psychosocial factors are involved.

Question ID

QS3N09Dthx6iyZ0RMq-erG

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