Pedemy All toolsEnter the dates and measurements; z-scores, malnutrition severity and weight-gain velocity are calculated for you, with a workup and treatment plan.
This calculator helps clinicians assess a child with growth faltering (failure to thrive) from birth to 20 years. From the sex, dates and measurements it calculates z-scores and percentiles, grades malnutrition severity, works out weight-gain velocity, and gives a workup and treatment plan. Preterm infants are plotted at corrected age until 2 years.
It uses WHO standards under 2 years and CDC charts from 2 to 20 years. Malnutrition is graded with the ASPEN/AND indicators, taking the worst one: a weight-for-length or BMI z-score of −1 or lower is mild, −2 or lower moderate and −3 or lower severe, and a length- or height-for-age z-score of −3 or lower counts as severe. An optional earlier measurement adds weight gain as a percentage of expected, weight loss over 2 years, z-score decline and percentile lines crossed. Growth faltering is flagged for a weight-for-length or BMI z-score under −2, crossing 2 or more major percentile lines, or weight gain under 75% of expected. Red flags such as dehydration, very low intake, unsafe swallow or safety concerns prompt admission advice.
Results include a catch-up energy and protein estimate, targeted labs, nutrition and feeding behavior advice, food insecurity screening, medicines, and refeeding safety steps. Sources include Tang et al. (Pediatr Rev 2021), the AND/ASPEN consensus (2015) and ASPEN refeeding recommendations (2020).
The tool uses the ASPEN/AND indicators and takes the worst one. A weight-for-length or BMI z-score of −1 or lower is mild, −2 or lower is moderate, and −3 or lower is severe. A length- or height-for-age z-score of −3 or lower also counts as severe.
In this tool, growth faltering is met by a weight-for-length or BMI z-score under −2, crossing 2 or more major weight percentile lines downward, or weight gain under 75% of what is expected to stay on the earlier weight curve.
The tool advises checking phosphorus, potassium, magnesium and glucose before feeding and every 12 hours for 3 days, starting at about 40–50% of goal calories and advancing by 10–25% a day while labs stay normal, and giving thiamine 2 mg/kg (max 100–200 mg) before feeding in high-risk children.
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