Growth Faltering and Failure to Thrive in Children

Area of Science:

• Pediatrics
• Nutrition Science
• Child Development

Background:

• Growth faltering, formerly failure to thrive, affects children failing to meet expected weight, length, or BMI milestones.
• Traditional growth assessment methods can be imprecise; anthropometric z scores are now recommended for accurate malnutrition severity assessment.
• Inadequate caloric intake is the primary cause, identified through feeding history and physical exams.

Purpose of the Study:

• To provide an overview of growth faltering diagnosis and management.
• To highlight the importance of updated assessment tools like z scores.
• To emphasize timely intervention for optimal child development.

Main Methods:

• Assessment using World Health Organization and Centers for Disease Control and Prevention growth charts.
• Utilizing anthropometric z scores for precise evaluation of malnutrition.
• Clinical evaluation including feeding history and physical examination.
• Diagnostic testing reserved for severe cases or treatment failure.
• Screening for eating disorders in older children or those with comorbidities.

Main Results:

• Inadequate caloric intake is the most common cause of growth faltering.
• Diagnostic testing is indicated for severe malnutrition, concerning symptoms, or treatment failure.
• Eating disorders should be screened for in specific pediatric populations.
• Primary care physicians can manage most cases, with multidisciplinary teams beneficial for complex cases.

Conclusions:

• Accurate assessment using z scores is vital for managing growth faltering.
• Early recognition and treatment, especially within the first two years, are critical.
• Untreated growth faltering can lead to reduced adult height and cognitive potential.