Failure to thrive or slower growth: medical, developmental / behavioral, nutritional and social dimensions

  • Diagnose stunting and childhood malnutrition.

  • Understand the pathogenesis and differential diagnosis of growth retardation.

  • Take a comprehensive relevant history starting with the prenatal period that includes parent height (if applicable), nutritional and dietary details, developmental progress, and social determinants of health.

  • Understand the role of diagnostic tests, including first-line laboratory tests such as complete blood count with differential count, iron studies, bypass, chemistry panel, and celiac assessment with immunoglobulin A and anti-tissue transglutaminase antibodies.

  • To assess growth retardation in specific populations of children with a history of prematurity, intrauterine growth retardation, short stature for gestational age, autism, and prenatal substance exposure.

  • Understand the role of social determinants in child undernutrition and screening and resources to address conditions of poverty and inequality, including, but not limited to, food insecurity.

  • Demonstrate cultural skills by counseling families on growth, nutrition and feeding.

  • Understand multidisciplinary treatment, including medical, nutritional and often behavioral / dietary therapy, and developmental and psychosocial support, with close monitoring, use of drug therapy when necessary, and collaboration between providers and programs.

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