Failure to thrive

Question 1

differentials?

Answer 1

INTAKE: poor suckling, ill health, lack of regular feeding, neglect, psychosocial deprivation.

RETENTION: gord/pyloric stenosis, vomiting

MALABSORPTION: coeliac, chrons, post NEC removal, cows milk protein allergy

UTILISATION: metablic disorders

REQUIREMENT: hyperthyroidism, cystic fibrosis, malignancy, chronic infection.

Question 2

Investigations:

Answer 2

growth chart completeion

FBC
U+E
LFT
TFT
Urinalysis + culture
Coeliac screen
sweat test

Question 3

Management

Answer 3

dietician

fall through 2 centiles - refer to paediatrician having done some of the relevant investigations and work up

social worker if neglect, may need health visitor to help.

special growth charts in syndromes