MONDAY, March 16, 2026 (HealthDay News) -- In a clinical practice guideline issued by the American Academy of Pediatrics, in partnership with the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, recommendations are presented for the diagnosis and management of faltering weight in young pediatric patients. The guideline is published online March 16 in Pediatrics.
Hans B. Kersten, M.D., from the St. Christopher's Hospital for Children at Drexel University College of Medicine in Philadelphia, and colleagues developed a clinical practice guideline to support health care providers caring for children with poor weight gain. The term "failure to thrive" was updated to faltering weight, and z-score cutoffs were used as diagnostic criteria.
The authors note that a diagnosis of faltering weight includes any of weight-for-length of body mass index (BMI)-for-age less than −1.65 z-score; weight gain velocity less than −2 z-score for age in children younger than 2 years; or decline in weight, weight-for-length, or BMI greater than or equal to 1 z-score. Eight Key Action Statements were provided and four Good Practice Statements were offered for additional guidance. Only children who have specific conditions that suggest a focal evaluation or persistent faltering weight are recommended to undergo diagnostic testing. Endoscopy with biopsy is suggested for children with persistent faltering weight or who have concerns for conditions that cannot be diagnosed without endoscopy. Use of increased calories of food/energy, oral nutritional supplementation, and therapy for pediatric feeding disorder are recommended.
"The guideline takes a whole-child approach to evaluation and treatment and recognizes that safe, stable, nurturing relationships are necessary components for normal growth and development," Kersten said in a statement. "The goals are to help doctors make accurate diagnoses, avoid unnecessary tests, and use health care resources wisely."