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Faltering growth

Última revisão: 11 Aug 2025
Última atualização: 16 Nov 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • faltering growth
  • signs of malnutrition
  • poor social history
  • poor quantity or quality of food or fluid intake
  • lack of clarity in communication between parent and child
  • abnormal feeding/eating behavior
  • perinatal complications
Detalhes completos

Outros fatores diagnósticos

  • family history of faltering growth
  • increased caloric loss
  • gastrointestinal symptoms
  • comorbid medical history
  • recurrent ear infections
  • recent surgery/burns
  • dehydration
  • cleft lip and/or palate
Detalhes completos

Fatores de risco

  • small for gestational age (SGA)
  • gastrointestinal problems (reflux, celiac disease)
  • poor caregiver knowledge
  • poor caregiver-child interaction
  • cerebral palsy
  • prematurity
  • poverty
  • lack of family mealtime routine
  • autism
  • chronic medical problems
  • allergies
  • swallowing disorder or history of choking
  • caregiver depression
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • according to clinical assessment
  • CBC
  • iron studies
  • chemistry panel
  • urinalysis
Detalhes completos

Investigações a serem consideradas

  • blood lead level
  • serologic testing for celiac disease
  • stool analysis
  • HIV testing or other infectious screen
Detalhes completos

Algoritmo de tratamento

AGUDA

all patients

Colaboradores

Autores

Howard Dubowitz, MD

Professor

Department of Pediatrics

University of Maryland School of Medicine

Baltimore

MD

Declarações

HD declares that he has no competing interests.

Maureen Black, PhD

Professor

Department of Pediatrics

University of Maryland School of Medicine

Baltimore

MD

Distinguished Fellow

RTI International

Research Triangle Park

Durham

NC

Declarações

MB declares that she has no competing interests.

Revisores

Kerri Gosselin, MD, MPH

Director of Pediatric Nutrition

UMass Memorial Children’s Medical Center

Worcester

MA

Declarações

KG declares that she has no competing interests.

Catherine Larson-Nath, MD

Assistant Professor of Pediatric Gastroenterology, Hepatology, and Nutrition

University of Minnesota

Minneapolis

MN

Declarações

CLN declares that she has no competing interests.

​Margot Tang, MD, MPH

Assistant Professor of Pediatrics

Boston University Chobanian & Avedisian School of Medicine

Boston Medical Center and Boston Children’s Hospital

Boston

MA

Declarações

MT declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Tang MN, Adolphe S, Rogers SR, et al. Failure to thrive or growth faltering: medical, developmental/behavioral, nutritional, and social dimensions. Pediatr Rev. 2021 Nov;42(11):590-603. Resumo

Becker P, Carney LN, Corkins MR, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). Nutr Clin Pract. 2015 Feb;30(1):147-61.Texto completo  Resumo

Kleinman R. American Academy of Pediatrics. Nutritional needs of the preterm infant. In: Kleinman RE, ed. Pediatric nutrition handbook, 5th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2004:36.

Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 11. 2002 May;(246):1-190.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Small but healthy
    • Small for gestational age
    • Prematurity
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Essential nutrition actions: improving maternal, newborn, infant and young child health and nutrition
    • Faltering growth: recognition and management of faltering growth in children
    Mais Diretrizes
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