A 5-month-old boy is brought to a regional general practice because he "is not filling out". Born at term weig…

Question

A 5-month-old boy is brought to a regional general practice because he "is not filling out". Born at term weighing 3.4 kg, he tracked along the 50th centile until 2 months and now weighs 5.6 kg, below the 3rd. He is bottle fed and has not started solids. His mother makes each bottle up according to the tin and then adds a further 60 mL of cooled boiled water "to keep his fluids up". He has no vomiting or cough, his stools are soft and formed, and he has had no fevers. He smiles, rolls and reache…

Accepted Answer

Over-diluted formula feeds

Answer

Occult urinary tract infection

Answer

Restrictive tongue-tie

Answer

Undiagnosed coeliac disease

Answer

Undiagnosed cystic fibrosis

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