Severe feeding problems represent one of the most frequent concerns in pediatrics. Feeding problems can affect as many as 5% of children, and estimates suggest 40% to 70% of children with chronic medical diagnoses experience feeding difficulties ( Sharp et al., 2017 Sharp W.G. Volkert V.M. Scahill L. McCracken C.E. McElhanon B. A systematic review and meta-analysis of intensive multidisciplinary intervention for pediatric feeding disorders: How standard is the standard of care?.

Journal of Pediatrics. 2017; 181 (e4): 116-124

). When infants present with poor growth, growth failure, and failure to thrive (FTT), providers often consider differential diagnoses that include gastroenterological and/or endocrine disorders but may also need to consider an underlying genetic cause. This case report of a 2-month-old who presented to an acute care facility with significant feeding difficulty and severe malnutrition describes the clinical course and diagnostic criteria for Russell–Silver syndrome. A comprehensive review of this genetic condition including genetic causes, clinical and genetic diagnosis, characteristic findings and presenting symptoms, treatment, and short- and long-term outcomes will be described.