Inadequate Caloric Intake: Despite the mother's report of adequate intake, the child's weight is below expected for corrected age, suggesting that the caloric intake might not be sufficient to support growth. The use of Ensure supplementation and blended foods may not be providing enough calories or nutrients for optimal growth.

Gastroesophageal Reflux Disease (GERD): Premature infants are at higher risk for GERD, which can lead to feeding difficulties and inadequate caloric intake.
Oral Motor Dysfunction: Premature infants may have oral motor difficulties that affect their ability to feed efficiently, leading to inadequate caloric intake.
Developmental Delay: Children with developmental delays may have feeding difficulties or poor appetite, leading to failure to thrive.

Cystic Fibrosis: A genetic disorder that can cause malabsorption and failure to thrive. It is essential to consider this diagnosis, as early intervention can significantly impact outcomes.
Celiac Disease: An autoimmune disorder that can cause malabsorption and failure to thrive. It is crucial to consider this diagnosis, as a gluten-free diet can lead to significant improvement.
Inborn Errors of Metabolism: Rare genetic disorders that can cause failure to thrive due to metabolic imbalances. Early diagnosis and intervention can significantly impact outcomes.

Hypothalamic-Pituitary-Adrenal Axis Disorders: Rare disorders that can affect growth hormone production, leading to failure to thrive.
Chronic Infections: Rare chronic infections, such as tuberculosis, can cause failure to thrive.
Genetic Syndromes: Rare genetic syndromes, such as Prader-Willi syndrome, can cause failure to thrive due to various mechanisms, including hormonal imbalances and feeding difficulties.