Mai is a 12 month old female who presents for a well child c…

Mai is a 12 month old female who presents for a well child check. Within the past 4 months, her weight has fallen from the 25th percentile to significantly less than the 5th percentile. Her height has dropped from the 10th percentile to slightly less than the 5th percentile, while her head circumference has remained at about the 25th percentile. Her language, motor, cognitive, and social development are normal. She seems to eat appropriate foods for her age, but her mother notes that she tends to be restless and fidgety while eating, and that she does not like the texture of certain foods, often leading to parental frustration at mealtimes. Her stools tend to be frequent and somewhat loose. Urine is normal. There are no symptoms of respiratory or neurological disease, and her review of systems is otherwise negative. Her past medical history is entirely unremarkable. She was born at term, weighing 3.0 kg (6 pounds, 10 ounces), without any perinatal complications. Her family history is negative for any endocrinopathies or chronic illnesses. Mother is 155 cm (5 feet, 1 inch) 61 inches tall, and father is 168 cm (5 feet, 6 inches). Mother experienced menarche at age 12.5 years and recalls that there were other children in the family who were deemed small as young children but who caught up later in childhood. Mother describes a history of increased sadness and worry since her child was born. Parents are married, and there is no history of abuse or violence in the household. Weight 7 kg (< 5th percentile), height 70 cm (5th percentile), head circumference 45.5 cm (50th percentile). HR 110 RR 28 SpO2 99% Review the Growth Grid. Given the data you are provided, what are your differentials? What additional information and data do you need? Provide rationale for your recommendations
Continue reading “Mai is a 12 month old female who presents for a well child c…”…