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Mechanism	Disorder
Decreased nutrient intake	Cleft lip or palate Central nervous system (eg, cerebral palsy) Gastroesophageal reflux disease Parasites Pyloric stenosis Rumination Eating disorders
Malabsorption	Celiac disease Cystic fibrosis Disaccharidase (eg, lactase) deficiency Inflammatory bowel disease Short gut syndrome
Impaired metabolism	Chromosomal abnormality (eg, Down syndrome, Turner syndrome) Fructose intolerance Galactose-1-phosphate uridyl transferase deficiency (classic galactosemia) Inborn errors of metabolism
Increased excretion	Diabetes mellitus Chronic kidney disease
Increased energy requirements	Bronchopulmonary dysplasia Cystic fibrosis Heart failure Hyperthyroidism Infection