The diagnosis of<unk>  relies on plotting the child's height and weight on a validated growth chart, such as the World Health Organization (WHO) growth charts for children younger than two years old or the U.S. Centers for Disease Control and Prevention (CDC) growth charts for patients between the ages of two and twenty years old. While there is no universally accepted definition for<unk> , the following are examples of diagnostic criteria for<unk> : * Weight under the 5th percentile among children of the same sex and corrected age; * Weight for length below the 5th percentile among children of the same sex and age; * Length for age below the 5th percentile; * Body mass index for age under the 5th percentile; * Weight for age or weight for length dropping by at least two major percentiles (95th, 90th, 75th, 50th, 25th, 10th, and 5th) on a growth chart; * Weight below 75% of the median weight for age; * Weight below 75% of median weight for length; or * Weight velocity less than the 5th percentile. After diagnosis, the underlying cause of<unk>  must be evaluated by a medical provider through a multifaceted process. This process begins with evaluating the patient's medical history. The medical provider will ask about complications during pregnancy and birth, health during early infancy, previous or current medical conditions of the child, and developmental milestones that have been reached or not reached by the child. The child's feeding and diet history, including overall caloric intake and eating habits, is also assessed to help identify potential causes of<unk> . Additionally, medical providers will inquire about any medical conditions that other members of the family may have, as well as assess the psychological and social circumstances of the child and family. Next, a complete physical examination may be done, with special attention being paid to identifying possible organic sources of<unk> . This could include looking for dysmorphic features (differences in physical features that may indicate an underlying medical disorder), abnormal breathing sounds, and signs of specific vitamin and mineral deficiencies. The physical exam may also reveal signs of possible child neglect or abuse. Based on the information gained from the history and physical examination, a workup can then be conducted, in which possible sources of<unk>  can be further probed through blood work, x-rays, or other tests. Laboratory workup should be done in response to specific history and physical examination findings. Medical providers should take care not to order unnecessary tests, especially given estimates that the usefulness of laboratory investigations for children with<unk>  is 1.4%. Initial bloodwork may include a complete blood count (CBC) with differential to see if there are abnormalities in the number of blood cells, a complete metabolic panel to look for electrolyte derangements, a thyroid function test to assess thyroid hormone activity, and a urinalysis to test for infections or diseases related to the kidneys or urinary tract. If indicated, anti-TTG IgA antibodies can be used to assess for celiac disease, and a sweat chloride test can be used to screen for cystic fibrosis. If no cause is discovered, a stool examination could be indicated, which would give information about the function of gastrointestinal organs. C-reactive protein and erythrocyte sedimentation rate (ESR) can also be used look for signs of inflammation, which may indicate an infection or inflammatory disorder.
Failure to thrive
Breastfeeding difficulties
Macroglossia
Stunted growth
Aglossia
Psychomotor retardation
Growth attenuation
Aphallia