What Work-Up Should Be Considered for the Infant or Toddler Who Is Gaining Weight Slowly? What Interventions Are Effective?

• Published in: Curbside Consultation in Pediatric GI pp. 93 - 96
• Main Author: Sinatra, Frank R.
• Format: Book Chapter
• Language: English
• Published: CRC Press 2013
• Edition: 1
• ISBN: 9781617110146; 1617110140
• DOI: 10.1201/9781003523635-22

Slow weight gain and/or poor linear growth may be present in up to 10% of infants and toddlers seen in a primary care setting and can occur as a result of multiple medical, environmental, and psychosocial insults. Before considering what type of work-up should be initiated, I try to determine the anthropometric phenotype (Table 18-1). The 3 basic types can be determined by the careful measurement of weight, height, and head circumference. In the first and most common type, weight is most prominently affected while height and head circumference are usually normal. Height may be affected, however, if the infant has suffered from chronic malnutrition. This pattern is usually the result of inadequate intake, absorption, or loss of nutrients or excessive nutrient requirements. In the second type, the weight and height are proportionately decreased and the head circumference is normal. This pattern is most common in infants with endocrine disorders, constitutional growth delay, and primary disorders of bone growth. A decrease in weight, height, and head circumference is seen in the third type and is most often associated with intrauterine growth retardation, metabolic, and central nervous system disorders.