11 2022 Failure to thrive

Failure to thrive is a common paediatric presentation. It is not just malnutrition but encompasses the developmental impact of poor nutrition. Failure to thrive is often a combination of inadequate energy (calorie) or protein intake, inadequate absorption of nutrients in the gut, increased energy utilisation, underlying infectious or genetic condition, psychosocial and environmental factors. It is important to understand each component to manage these children properly. We will discuss the assessment of a child with failure to thrive, the stages of management of severe malnutrition according to WHO and Standard Treatment guidelines, and how to identify and manage refeeding syndrome, which can cause patients to deteriorate after recommencing feeds.