Symptoms:

• Decreased or absent linear growth ("falling off" the growth chart)
• Lack of appropriate hygiene
• Interaction problems between mother and child
• Weight less than the 5th percentile, or an inadequate rate of weight gain

Signs and tests:

Careful evaluation by a doctor is the first step. A physical exam, medical history, and simple laboratory tests can be used to rule out major medical illnesses as the cause. The doctor will closely examine the patient's growth chart.

The doctor should involve family members and social service agencies to help the mother. A child's feeding should be gradually increased to 150 calories/kg/day.

If the doctor is concerned for the child's safety or treatment has not been successful, the child may need to stay in the hospital.