A picture is worth a thousand words

The diagnosis of weight faltering can be challenging and often controversial. The determination should be made based on careful evaluation of growth parameters, including longitudinal patterns plotted on age- and gender-appropriate growth charts. For children with suspected or diagnosed weight faltering, the initial work-up should be limited, with laboratory tests and studies directed by findings on history and physical examination. Treatment should include nutritional counselling, familial support, and close outpatient follow-up. Hospitalisation may be useful in some cases but should not be used routinely to assist in the diagnostic work-up. Patients with limited response to these interventions may require further evaluation.