Author
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DURYEA, TERESA - Baylor College Of Medicine |
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MOTIL, KATHLEEN - Children'S Nutrition Research Center (CNRC) |
Submitted to: Book Chapter
Publication Type: Book / Chapter Publication Acceptance Date: 11/30/2017 Publication Date: 1/9/2018 Citation: Duryea, T., Motil, K.J. 2018. Poor weight gain. In Kline, M.W., Blaney, S.M., Giardino, A.P., Orange, J.S., Penny, D. J., Schutze, G.E., Shekerdemian, L.S., editors. Rudolph's Pediatrics. 23rd edition. Volume 1. New York, NY: McGraw-Hill Education. p. 98-101. Interpretive Summary: Technical Abstract: Poor weight gain is the finding of weight loss or a deceleration in the rate of weight gain in children under age 2y who have an abnormally low weight relative to their stature for age and gender. Three mechanisms underlie poor weight gain: inadequate nutrient intake, insufficient utilization or impaired absorption of nutrients, or increased metabolic requirements. Most commonly, poor weight gain results from inadequate nutrient intake due to insufficient food offered, chewing and swallowing dysfunction, or behavioral problems that limit a child's dietary intake. The evaluation of a child with poor weight gain consists of a thorough medical history, a detailed record of nutritional intake and feeding practices, physical assessment of the nutritional state and identification of signs of underlying medical or genetic disorders that interfere with growth, accurate measurement and interpretation of the child's growth parameters, and selected laboratory investigations where appropriate. The management of poor weight gain is comprised of initially involves nutritional counseling and dietary interventions. Management goals include increasing nutritional intake, evoking catch-up growth, resolving feeding difficulties if possible, and strengthening positive feeding interactions between parent and child. Hospitalization for evaluation and nutritional intervention may be necessary for severe malnutrition. Cognitive recovery in children with poor weight gain appears to mirror their nutritional recovery, emphasizing the need for quick nutritional intervention for these children. |