Children will often present to the ED with concern for poor feeding or weight loss. Be concerned about failure to thrive when: 2 or more growth percentile lines are crossed or weight or length is less than the 5th percentile for the patients chronological age.
Make sure to ask about feeding technique, type of formula, frequency of feeds and problems with feeding.
Keep a broad differential in the ED in children with weight concerns including non accidental trauma, congenital heart disease, genetic abnormalities, hyperthyroidism, and gastrointestinal abnormalities. GI problems include cow's milk protein intolerance, celiac disease, pyloric stenosis and reflux.
Calleo V, Surujdeo R and Thabet A. Emergency Department Management of Patients with Failure to Thrive. EB Medicine. March 2020.