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Failure to thrive
APCToday, 10/22/09

Schmalz M et al. – A 13–month–old girl arrives at your clinic, referred by the staff at the Women, Infants, and Children (WIC) nutritional center where her parents—recent immigrants from Africa—go for food supplements. The baby is bundled up in layers of clothing, even though it’s a relatively mild winter day. The father carries her into the examining room and undresses her. The child is tiny and dark–skinned, with curly hair painstakingly divided into little bunches. The parents seem caring, loving, and not particularly worried. They tell you the nurse at the WIC center thought their baby was not gaining enough weight and advised them to bring the baby to you. The referral note from WIC says hemoglobin levels found on routine blood test were low. You list the presenting complaint as anemia.

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