• Bright Futures prefers the term pediatric undernutrition to failure to thrive.

  • Thorough history and physical examination are the keys to diagnosis, with laboratory evaluation most often not helpful.

    • Comprehensive feeding and social histories are key.

    • Detailed anthropometric measurements over time are critical.

  • The severity of the child’s condition dictates the approach to treatment, which should focus on nutritional rehabilitation, parental education, and behavioral intervention.

  • Although most children with mild undernutrition do well with adequate follow-up, more severely affected children need aggressive interventions to mitigate developmental, behavioral, and social morbidity.

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