Growth failure without other disease is one of the early symptoms of difficulty in parenting often associated with other signs of neglect and abuse. Although the cause of the malnutrition is lack of adequate calories, the problem usually occurs in the context of a moderately or severely disturbed parent-child relationship resistant to simple re-education of the parents about feeding practices. Treatment for the child's nutritional state and for improvement of the environmental deprivation in the home must extend until the child is at least 3 years old, because the risk of relapse is high. Intervention should focus on helping parents become more effective in coping with their own problems and on helping them become more empathic to their child's needs. Some parents are not capable of caring for the child at the outset of treatment, requiring foster care until the parents are capable of caring for the child. Other parents, for reasons of mental illness, mental incapacity, or the degree of parenting problems, are unable to care for their child, such that the termination of parental rights is in the best interests of the child. Parenting difficulties manifested in inadequate feeding and growth failure will continue to limit the child's future development unless prolonged and effective family treatment is possible. Better treatment strategies and preventive measures are required. 60 references.