New AAP Guideline on Faltering Weight in Children

Clinical Takeaway

: In its first guideline on the topic, the AAP recommends against broad evaluation for all children and affirms standard nutritional therapy.

An overview of the 2026 Clinical Practice Guideline for Diagnosis and Management of Faltering Weight from the American Academy of Pediatrics (AAP)

Background

Growth parameters are vital signs in children, and pediatricians commonly encounter patients who do not meet growth milestones. For the first time, the AAP offers guidance on diagnosing and managing this condition.

Key Points

“Faltering weight” is now preferred over “failure to thrive,” which was inconsistently defined and cast blame on caregivers.
Diagnosis: Faltering weight should not be defined by growth percentiles (which are less precise) but by Z-scores (i.e., standard deviations from the mean):
- Z-score <−1.65 in weight-for-length (in children <2 years of age) or body-mass index (BMI)-…

Reviewing Author

Clement D. Lee, M.D., M.Sc.

Disclosures

Nothing to disclose