When Brian Peltz opened his small sandwich shop 16 feet from the emergency room entrance of the new Children's Hospital of Pittsburgh of UPMC site in Lawrenceville, he was confident that business would be brisk once the hospital opened on May 2.

Now, 2¹/₂ months later, Mr. Peltz is worried about whether his shop on 44th Street, The Lunchbox of Pittsburgh, will survive.

"I have not seen an overwhelming increase of business," he said. "The only increase of business is the smokers, because UPMC policy is that you can't smoke on their property."

A similar story comes from the Penn Main Cafe across from the hospital's main entrance on Penn Avenue.

"To be honest with you, it's gotten really slow now," said Kevin McDonnell, whose wife, Kathleen, owns the cafe. "It's gone the opposite way we thought. Before we had all the construction workers."

Local businesses and residents have had years to build up their expectations for the $625 million hospital, which moved from Oakland into the site formerly occupied by St. Francis Hospital. And no places had higher hopes then the restaurants and cafes within walking distance of the hospital. They saw a future full of long lines and crowded dining rooms. Instead, little has changed.

In February, Brillobox owners Eric and Renee Stern decided to add lunch hours to their popular hipster nightclub. Their menu includes options like Nicoise salad and a Brillobox gyro with skirt steak or chicken. "There is some lunch traffic but at the moment it hasn't measured up to our desires or expectations," Mr. Stern said.

The Brillobox is just one of several dozen lunch options within a 10-minute walk, but staff and visitors don't need to leave the hospital at all to find a variety of choices. The new hospital offers a much upgraded cafeteria compared to what it offered in Oakland. Beyond the regular burgers, fries and comfort food, it now offers packaged salads, sushi rolls with avocado and brown rice, pork chops with orange mustard sauce and bowls of corn bisque with asparagus and herbs. There's even an outdoor patio with umbrella-covered tables. A complete lunch can be had for as little as $5.

Eric Hess, Children's vice president and project executive, said the hospital has made a concerted effort to help local businesses, such as putting information about local restaurants and other neighborhood amenities on the staff Intranet.

"We put [the cafeteria] right in the core of the building and we made a conscious decision not to put retail food stores on the perimeter of the building ... to try not to be competitive with the businesses that are there and to encourage development along the corridor," he said.

Instead, most of the area's development seems to be happening a few miles away, on the thriving stretch of Butler Street -- from 34th to 39th Street -- known as Lower Lawrenceville. One of the newest additions is Tamari at 3519 Butler, a Latin-Asian fusion restaurant that is this summer's most talked about opening. Owner Allen Chen credits the new hospital with inspiring the redevelopment that attracted him to Lawrenceville in the first place.

Maya Haptas, business district manager for the Lawrenceville Corp., emphasized other factors.

"I don't really think that there's a correlation between Butler Street thriving and the hospital," she said. "I think it's because of the small business owners who are so committed to the neighborhood. They volunteer their time; they've worked to get people into the neighborhood."

Continued development still holds promise for the neighborhoods bordering Children's Hospital. Ms. Haptas believes that as medical offices and related businesses open near the hospital, street traffic may increase. But change, if it comes, will be slow and steady.

At least one restaurant does seem to be attracting a number of new customers. A banner across the front of Del's Restaurant in nearby Bloomfield welcomes friends and family of Children's Hospital and offers a 20 percent discount to anyone with an I.D. tag.

"We're getting a lot of lunch business from Children's. They've always taken advantage of the 20 percent coupon. And that goes for all UPMC and West Penn staff as well," said owner John DelPizzo.

Meanwhile Mr. Peltz at The Lunchbox has managed to attract more business by holding outdoor barbecues, but he doesn't know what he'll do once the weather is cold.

"I want to contribute to the city and the community and have more employees and make that whole circle complete, but unfortunately, it hasn't been everything that I hoped it would be," he said. "But we're obviously here for the long haul."