What should you know about the etiology of failure to thrive?

Some children take in too little energy because feeding is difficult, appetite is poor, meals are stressful, or swallowing and chewing are hard. Others may not absorb nutrients well because of digestive problems. A long-term heart, lung, kidney or hormonal condition can increase the body's needs or make eating tiring.

Growth is interpreted over time using measurements, birth history, development and family pattern. One measurement cannot explain the cause, and a naturally smaller child may be healthy. The assessment also considers feeding routines, behaviour, medicines and the home environment.

Arrange a child health assessment rather than trying to force larger meals. Bring a record of what the child eats and drinks, feeding times, vomiting or diarrhoea, and any changes in energy or development. Continue offering age-appropriate food and fluids calmly while awaiting advice.

The clinician may observe a feed, review growth measurements, examine the child and decide whether targeted tests or support from a dietitian, feeding specialist or other professional is useful.

Seek prompt care if a child is unusually sleepy, struggles to breathe, cannot keep fluids down, has signs of dehydration, loses weight quickly, or has a marked change in development. Babies who feed poorly or have fewer wet nappies need timely assessment.

Ask which growth measurements have changed, what causes fit the child's history, whether feeding observation is needed, and what signs should prompt an earlier review. Clarify the next practical feeding goal and how progress will be monitored.