title: Failure to thrive in babies and toddlers.
abstract: Failure to thrive in a child is defined as 'lack of expected normal physical growth' or 'failure to gain weight'. Diagnosis requires repeated growth measurements over time using local, age-appropriate growth centile charts. Premature babies with appropriate growth velocity and children with 'catch-down' growth, constitutional growth delay or familial short stature show normal growth variants, and usually do not require further evaluation. In Singapore, the most common cause of failure to thrive in children is malnutrition secondary to psychosocial and caregiver factors. 'Picky eating' is common in the local setting and best managed with an authoritative feeding style from caregivers. Other causes are malabsorption and existing congenital or chronic medical conditions. Child neglect or abuse should always be ruled out. Iron deficiency is the most common complication. The family doctor plays a pivotal role in early detection, timely treatment, appropriate referrals and close monitoring of 'catch-up' growth in these children.
authors.affiliation: Division of Family Medicine, Department of Medicine, National University Health System, Singapore.
authors.forename: Lay Hoon
authors.initials: LH
authors.lastname: Goh
authors.affiliation: Care and Health Integration, Changi General Hospital, Singapore.
authors.forename: Choon How
authors.initials: CH
authors.lastname: How
authors.affiliation: Department of Paediatrics, National University of Singapore, Singapore.|Division of Paediatric Nephrology, Dialysis and Renal Transplantation, Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore.
authors.forename: Kar Hui
authors.initials: KH
authors.lastname: Ng
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D002149:Energy Intake; D005183:Failure to Thrive / Q000175:diagnosis* / Q000628:therapy*; D006130:Growth Disorders / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D011320:Primary Health Care / Q000379:methods*; D012017:Referral and Consultation
keywords: constitutional growth delay; familial short stature; fussy eater; malnutrition