Maternal and Child Health Bureau HomeModule IntroTable of ContentsGlossary
Training Module: Poor Growth

Evaluating reasons for poor growth
Choose a sectionSection 1Section 2Section 3Section 4Section 5

4. Evaluation of reasons for poor growth

Children who appear to be growing poorly may be quite normal, or they may have medical or nutritional problems. There are many possibilities.

Check Normal reasons for apparently poor growth include family patterns of growth. Children may be short because their parents are short, or thin because their parents are thin; they may be short during childhood and grow in late adolescence, if that is their family pattern. However, one should not make such conclusions without evaluating the child, nor should one make such conclusions if the parents' growth might have been impaired, as by undernutrition in a developing country.
Check Nutritional causes can include low-nutrient food choices (for example, too much juice pushing out other more nutrient-dense foods) and difficulties in feeding (for example, children with physical problems who cannot tolerate certain textures or toddlers who don't want to be fed).
Medical causes can include frequent ordinary illnesses, such as diarrhea and ear infections, and unusual conditions, such as cystic fibrosis and genetic disorders. Low-birth-weight infants often grow slowly (see the module, Use of the CDC Growth Charts with Children with Special Health Care Needs).

Children whose growth appears poor on charts may require services from clinicians or professionals in more than one field: nutrition, medicine, child development, and others. Results of an evaluation may range from normal to the discovery of serious problems.

Evaluation is especially important if the child is young (for example, in the first few months of life, rather than age 2 years), if the growth deviation is severe, or if there are symptoms of illness, clues to problems in feeding or family relationships, or unusual feeding practices. Evaluation is accomplished most effectively by a multidisciplinary team, but referrals to registered dietitians, feeding specialists, medical providers, and mental health professionals can also accomplish the work.

Back Next