Weight-Faltering in Infants and Children (Failure to Thrive)

Weight-faltering in infants and children, otherwise known as failure to thrive, is a common occurrence in pediatrics. It is not a diagnosis itself but rather a sign of malnutrition to such a degree that optimal growth and development is impacted. Your job as the clinician treating these patients is to conduct a thorough and detailed history, review of systems, and physical exam to uncover the underlying etiology of poor weight gain. Most often in this age group, the root cause is inadequate oral intake, which can occur for many reasons and is often multifactorial in nature. Any laboratory or imaging evaluation should be based on clues from the history and physical exam. Routine laboratory screening is not necessary in most cases. Most of the care for patients with weight-faltering can occur in the outpatient setting with close follow-up and caregiver guidance.