Signs and symptoms
Failure to thrive is most commonly diagnosed before two years of age, when growth rates are highest, though FTT can present among children and adolescents of any age. Caretakers may express concern about poor weight gain or smaller size compared to peers of a similar age. Physicians often identify failure to thrive during routine office visits, when a childs growth parameters such as height and weight are not increasing appropriately on growth curves. Other signs and symptoms may vary widely depending on the etiology of FTT. It is also important to differentiate stunting from wasting, as they can indicate different causes of FTT. "Wasting" refers to a deceleration in stature more than 2 standard deviations from median weight-for-height, whereas "stunting" is a drop of more than 2 standard deviations from the median height-for-age.The characteristic pattern seen with children with inadequate nutritional intake is an initial deceleration in weight gain, followed several weeks to months later by a deceleration in stature, and finally a deceleration in head circumference. Inadequate caloric intake could be caused by lack of access to food, or caretakers may notice picky eating habits, low appetite, or food refusal. FTT caused by malnutrition could also yield physical findings that indicate potential vitamin and mineral deficiencies, such as scaling skin, spoon-shaped nails, cheilosis, or neuropathy. Lack of food intake by a child could also be due to psychosocial factors related to the child or family.
Onychoatrophy is a faulty underdevelopment of the nail that may be congenital or acquired, in which the nail is thinned and smaller. : 784 


== References ==