Clinical Definition:

1. weight <5th percentile,
2. or crossing 2 percentile lines (each line is 25th percentile, so dropping by over 50th percentile)

Physical Exam

• Neonate Nutrition Assessment
• Pediatric Growth Assessment

Signs

• Mid-parental height

DDx

1) Intake Problem

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1. Poor feeding  (main cause in < 1yo)

   • Often more chronic
   • Social: can’t afford food, parents didn’t know they need food
   • Psychosocial (screen for Post-partum Depression , neglect, health literacy)

   

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1. Physical issue
   • Mother: Insufficient Lactation (Breast Feeding)
   • Baby: Oropharyngeal problem/swalling problem (CP, down)
     • Ankyloglossia, cleft palate/cleft lip
     • Oromotor dysfunction
     • GERD or GER
2. Picky eater
3. Food aversions
   • GERD
   • chronic Constipation
   • Toxin-induced Anorexia (loss of appetite)

3) Absorption Problem

1. Autoimmune Disease (e.g. IBD , CF - Cystic Fibrosis , Celiac Disease )