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
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
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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- according to clinical assessment
- CBC
- iron studies
- chemistry panel
- urinalysis
Investigações a serem consideradas
- blood lead level
- serologic testing for celiac disease
- stool analysis
- HIV testing or other infectious screen
Algoritmo de tratamento
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
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 diferenciaisDiretrizes
- Essential nutrition actions: improving maternal, newborn, infant and young child health and nutrition
- Faltering growth: recognition and management of faltering growth in children
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