10 Possible Reasons Why Your Child Isn’t Growing
Poor weight gain is an common problem for children. Find out likely causes and when to seek help.
Contributor: Kadakkal Radhakrishnan, MD
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Poor weight gain is a common problem for children. Poor weight gain is typically noticed by the parents (usually the mother) or primary physician, who notice that the child isn’t growing well – or their weight gain deviates from a normal growth pattern. When that weight trend is poor, doctors may describe the child as “failing to thrive” or “malnourished.”
Often, the trend in weight over time is more important than a single drop in weight measurement. It’s important for weight to be compared to height to ensure that the child is gaining weight well in comparison to his or her height. This height and weight correlation is plotted using a weight for length chart or Body Mass Index chart.
Sometimes, toddlers will lose weight as they become more active. In this circumstance, their weight may drop in relation to their height, but the child will still continue to progress at a normal rate for their age.
When there is a significant drop in weight with a single measurement, that may be concerning. In this situation, the child will have to be seen by a doctor and re-measured in order to see if the drop in weight is significant enough to warrant further action.
If you’re concerned that your child is not gaining weight well, you should seek the help of your child’s primary care provider. The child would need a good physical exam, and his or her doctor should be looking for signs of medical disorders other than simply inadequate caloric intake.
The BMI chart may need to be closely monitored, and your child may need frequent follow-ups and weight checks during this time. Negative signs from the exam would be fatigue, paleness, thin extremities, loose folds of skin on the arms and thighs, and loss of fat over the cheeks. The provider may run tests to evaluate for anemia, nutritional status and kidney function.
Based on the clinical assessment, further tests may be ordered to check for possibilities of celiac disease, Crohn’s disease or a pancreatic enzyme deficiency. For these, the provider may seek the help of a specialist like a pediatric gastroenterologist or pediatric dietitian.
Most children require subtle increases in their caloric intake to improve weight gain. This may require some imagination on the part of parent, and extra calories could be in the form of additional oil, sugar or special formulas in the diet. Interestingly, growth only requires 5 to 10% of the total caloric intake after six months of life.
A child with persistent poor weight gain despite increase in caloric intake may require admission to the hospital to observe weight and feeding trends and for testing and evaluation by a pediatric dietitian. Children with persistent poor weight gain may need be started on supplementary feeding though tubes placed into the stomach through the nose called naso-gastric feeding.
Certain medications that stimulate appetite may be beneficial in some children. Diet modification in the form of a gluten-free diet will be required for celiac disease. Digestive enzyme supplementations will needed to aid pancreatic enzyme. And the help of specialists should be sought to treat heart problems, Crohn’s disease, thyroid problems or pyloric stenosis.
This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.