A feeding disorder is the failure of a baby or young child to get enough nutrition. This can lead to malnutrition. A feeding disorder causes weight loss, or a failure to gain weight as expected for the child’s age. This failure to gain weight and grow because of inadequate nutrition is sometimes called failure to thrive. Failure to thrive is defined as weight below the 3rd to 5th percentile for age and sex, or a decrease in 2 major percentiles of growth in a short period of time. Other symptoms include constipation, fussiness, excessive crying, and the child's loss of interest in their surroundings.
A feeding disorder may occur because the child isn't getting the right amounts or types of food. Or it may be due to how the parent or caregiver interacts with the child. Or it could be because of or other psychosocial stressors in the home. Sometimes the exact cause can't be found.
Childhood malnutrition is a very serious condition. If untreated, it can have lasting (permanent) effects on the child’s mental and physical development.
Treatment includes increasing the child’s daily calories and fluids. If the child is low on vitamins or minerals, the healthcare provider may advise certain foods or supplements. The provider will look for and treat any illness that may also be present. This may involve some lab tests. You will be given information about the best diet to feed your child. This can be a difficult problem to solve. A team approach may be needed. If there is no medical reason found for your child's failure to thrive, the provider will look for emotional or social reasons to account for the feeding disorder. The team may include a healthcare provider who specializes in treating babies and children (a pediatrician), a dietitian, social workers, and visiting nurses. In severe cases, your child may need a hospital stay so that staff can watch feeding patterns and record weight. In very extreme cases, your child may need tube feedings if they aren't getting enough calories by mouth.
Home care
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Follow the healthcare provider’s plan for changes to diet and fluid intake.
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Keep regular appointments with the healthcare provider to watch your child’s growth and development.
Follow-up care
Follow up with your child’s healthcare provider as advised.
When to get medical advice
Call your child’s healthcare provider right away if any of these occur:
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Your child vomits repeatedly
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Your child has continued or severe diarrhea
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Your child has blood in their vomit or stool
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Your child has belly (abdominal) swelling
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You can't soothe your child
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Your child shows abnormal fussiness, drowsiness, or confusion
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Your child has no tears when crying, "sunken" eyes, or a dry mouth
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Your child hasn't needed to pee in the past
6 to 8 hours (in older children) or hasn't had a wet diaper for4 to 6 hours (in babies and younger children) -
Fever (see Fever and children below)
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.
Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.
When to call a healthcare provider about your child’s fever
For a baby under 3 months old:
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First, ask your child’s healthcare provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the provider
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the provider
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the provider
