Pediatric Malnutrition and Failure to Thrive

Pediatrician talking to a girl about nutrition.

When Your Child Needs Nutritional Support

Proper nutrition is the foundation for a long, healthy life. When a child struggles to reach a healthy weight or parents have difficulty providing proper nutrition—we offer nutrition resources for the care your child needs.

Failure to Thrive 

"Failure to thrive" is a diagnosis term describing a lack of age-appropriate weight gain. If left untreated, this condition can bring about developmental delays and long-term effects on your child’s health. Failure to thrive is often one symptom of an underlying disease state, which can lead to the diagnosis of malnutrition.

Pediatric Malnutrition

Your doctor or dietitian will diagnose and specify the severity of malnutrition based on approved criteria. These may include:

  • weight gain velocity
  • stature growth velocity
  • mid-upper arm circumference
  • current diet and intake
  • weight loss
  • physical examination

Malnutrition can affect all ages, but it can lead to long-term effects if left untreated in pediatric patients. Those effects include growth stunting, vitamin and mineral deficiencies, loss of functional status and developmental delays. Pediatric malnutrition can be mild, moderate or severe depending on various diagnosis criteria.

Malnutrition Causes 

Causes of malnutrition can be illness or non-illness-related. Certain illnesses may require increased protein and caloric intake for a variety of reasons. If caloric needs are not met, the result is inadequate growth or weight loss, which can lead to malnutrition if untreated. Non-illness causes like environmental, behavioral and socioeconomic factors can often lead to reduced food and beverage intake—often resulting in inadequate growth or weight loss.

Management for Malnutrition

Effective management of pediatric malnutrition is a multidisciplinary approach that addresses the biological, physiological and social factors underlying a child’s growth. To ensure optimal long-term health outcomes, your care team may include a:

  • physician
  • dietitian
  • speech-language pathologist
  • physical therapist
  • occupational therapist
  • social worker
  • behavioral psychologist

Treatment relies heavily on the management of the underlying disease state. A dietitian can help provide strategies that reinforce proper nutrition for children of all ages. This often involves educating parents and guardians on feeding instructions like:

  • fortifying formula or breast milk
  • high calorie and protein diets
  • oral nutrition supplements
  • enteral nutrition
  • total parenteral nutrition (TPN) in severe cases

A social worker can assist with resources such as:

  • Women Infants and Children (WIC)
  • Supplemental Nutrition Assistance Program (SNAP)
  • Food pantries
  • Other support systems to help minimize stress

Dietary Recommendations for Malnutrition  

Most children with malnutrition will show improved weight trends and nutritional intake with intervention. Specific dietary recommendations will be provided by a Clinical Dietitian during a consultation visit and vary widely on a case-to-case basis. To be seen by a Driscoll Dietitian, please consult your child’s specialist or request a referral from your child’s Primary Care Physician.  

Bunting, K. Dawn, and Steven Abrams. Pediatric Nutrition Reference Guide 2011. Texas Children's Hospital, 2016.

Kleinman, Ronald E., and Frank R. Greer. Pediatric Nutrition. 8th ed., American Academy of Pediatrics, 2020.

Sonneville, Kendrin, and Christopher Duggan. Manual of Pediatric Nutrition. 5th ed., People's Medical Publishing House - USA, 2014.

Smith AE, Badireddy M. Failure To Thrive. [Updated 2022 Oct 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:  


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