Failure to thrive

Clinical assessment, including measurement of height and weight, assessment of growth over time.

Urine - microscopy and culture

Reduced nutrient availability

Dietary deficiency

Vomiting

Diarrhoea, including

• Malabsorption, especially
  • Cystic fibrosis
  • Coeliac disease
  • Food intolerance

See under Diarrhoea.

Intestinal infection

Increased nutrient requirements

Infection, especially

• Urinary tract infection
• Respiratory infection
• Giardiasis

If not apparent, consider possibility of occult infection: FBC, differential WCC, blood film, ESR or CRP may be helpful.

See under Cough - chronic.

Immunodeficiency, especially

• AIDS

Inborn errors of metabolism

Rare causes, consider if above excluded; consult pathologist