6m old came with Failure to thrive
Baby is underweight; please advise the query opportunities and PDX
Progness note writing Failure to thrive
BMI < 5th Percentile
Baby is underweight; please advise the query opportunities and PDX
Progness note writing Failure to thrive
BMI < 5th Percentile
Comments
Hopefully the RD has been consulted. We would most likely look to the RD evaluation and assessment to guide queries.
I would also look carefully for any hints as to etiology -- new medications, any difficulties with feeding (mechanical / dietary intolerance / etc.)
Don
I agree with Don. RD consult is important. However, lots to consider here. If the baby is <28d I would be looking to support the query with any birth information that was pertinent. The focus on risk factors can run the spectrum depending on age and co-morbidities as well as SDOH. In terms of query opportunities, obviously specified malnutrition, endocrine diagnoses, GI diagnoses. FTT can be used as the PDX for example, in the situation where the baby is admitted and demonstrates good weight gain in the hospital and it is determined that the FTT was due to mixing formula incorrectly, for example or not feeding enough volume or only feeding formula or milk well beyond when the child should have been taking solids. But if true malnutrition is present, malnutrition is usually the medical diagnosis while FTT is the manifestation of such.
This is a little though to answer without more details but hope that helps.
You can calculate the baby's Z score via the WHO calculator for weight for length to see if meets mild/moderate/severe malnutrition. Dietitian consult is helpful but not always done/ordered.