Last reviewed: 2 Feb 2021
Last updated: 13 Jan 2021
Summary
Definition
History and exam
Key diagnostic factors
- 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
Other diagnostic factors
- family history of faltering growth
- increased caloric loss
- gastrointestinal symptoms
- comorbid medical history
- recurrent ear infections
- recent surgery/burns
- signs of dehydration
- cleft lip and/or palate
- signs of abuse or neglect
Risk factors
- small for gestational age
- gastrointestinal problems (reflux, celiac disease)
- poor caregiver knowledge
- poor caregiver-child interaction
- cerebral palsy
- prematurity
- poverty
- food insecurity
- lack of family mealtime routine
- autism
- other medical problems (e.g., fever, cardiac abnormalities)
- allergies
- swallowing disorder or history of choking
- caregiver depression
Diagnostic investigations
1st investigations to order
- according to clinical assessment
- CBC
- urinalysis
- serologic testing for celiac disease
Treatment algorithm
Contributors
Authors
Professor
Department of Pediatrics
University of Maryland School of Medicine
Baltimore
MD
Disclosures
HD declares that he has no competing interests.
Professor
Department of Pediatrics
University of Maryland School of Medicine
Baltimore
MD
Disclosures
MB declares that she has no competing interests.
Peer reviewers
Associate Professor of Pediatrics and Family Medicine
Department of Pediatrics
Hasbro Children's Hospital
Providence
RI
Disclosures
RR declares that he has no competing interests.
Professor of Pediatrics
Mayo Clinic
Rochester
MN
Disclosures
PF declares that he has no competing interests.
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