Differentials
Small but healthy
SIGNS / SYMPTOMS
By definition, 5% of children will track below the 5th percentile on growth charts. A consistent trajectory suggests they are small, but healthy. Indicators of whether the child is small but healthy or experiencing faltering growth include: past medical history, feeding behavior, development, physical exam, and lack of response to feeding changes.
INVESTIGATIONS
Clinical diagnosis.
Small for gestational age
SIGNS / SYMPTOMS
Infants with compromised in utero growth (small for gestational age) often have poor postnatal growth, particularly if growth parameters are similarly affected (i.e., symmetrical poor growth).
INVESTIGATIONS
Clinical diagnosis.
Prematurity
SIGNS / SYMPTOMS
Infants with prematurity often have poor postnatal growth, especially if there are associated complications, such as lung disease. Gestational age needs to be factored into interpretation of growth, using appropriate growth charts.
INVESTIGATIONS
Clinical diagnosis.
Measurements should be plotted on appropriate growth charts and corrected for gestational age as appropriate until 2 years of age.
Use of this content is subject to our disclaimer