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Understanding faltering growth in primary care settings

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Faltering growth occurs in the early days of life Faltering growth occurs in the early days of life where energy intake does not meet the child’s energy requirements

Faltering growth is a term used to describe a slower rate of expected weight gain in infants and children according to their expected growth trajectory for age and sex and is identified in about 5% of infants and preschool children.1 Faltering growth has replaced the more negative term, ‘failure to thrive’.1,2

Concerns about children with faltering growth are usually raised by parents, or health professionals during routine screening for health and development, with the vast majority of cases managed in primary care.2 This article looks at the common reasons for faltering growth and discusses how to assess and treat, based on the NICE Guidelines.2

Faltering Growth

NICE guidance2 has distinguished between ‘weight loss in the early days of life’, and ‘faltering growth after the early days of life’.

Weight loss in the early days of life is a physiologically normal event where babies, usually in the first 3-4 days of life can lose up to 10% of their body weight due to fluid shifts. Most infants recover their birth weight by 3 weeks of age.2 This phenomenon is dealt with by feeding assessment, and infant feeding support, see NICE Guideline CG373 for further information.

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