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Faltering Growth

Summary

Faltering growth, previously known as “failure to thrive,” is a condition in which a child’s weight or growth rate is below what is expected for their age. It requires careful monitoring of weight, height, and head circumference over time.

To determine the cause, a comprehensive evaluation is necessary. This includes reviewing medical history, family routines, food availability, meal patterns, and the child’s participation in mealtimes. While medical tests may be performed if needed, they are generally guided by a child’s history and physical examination rather than done routinely.

Faltering growth can be stressful for families, regardless of the cause. It can lead to anxiety and conflicts around feeding, even when there is an underlying medical condition. The condition affects children across all socio-economic backgrounds but may be more common in families with financial hardships or multiple risk factors.

Diagnosis and When to Seek Help

If your child is not gaining weight as expected, appears underweight, or has a slow growth rate, it is important to consult a healthcare provider. Other signs may include:

  • Reduced appetite or difficulty eating
  • Low energy levels or delayed developmental milestones
  • Persistent digestive issues, such as vomiting or diarrhea

A doctor will assess growth patterns using standardized growth charts and evaluate dietary intake, feeding routines, and social factors. Extensive medical tests are usually not necessary unless there are specific concerns based on the child’s history or physical examination.

Management

Addressing faltering growth involves an interdisciplinary approach, which may include:

  • Nutritional support: Ensuring adequate calorie and nutrient intake through diet changes or supplements if needed.
  • Behavioral and feeding strategies: Encouraging positive mealtime experiences, minimizing stress, and promoting structured meal routines.
  • Medical and psychosocial support: Addressing any underlying medical conditions and providing guidance for families experiencing stress or food insecurity.
  • Collaboration with specialists: Involving doctors, nutritionists, psychologists, and social workers to develop a tailored plan for the child’s growth and well-being.

Hospitalization is only considered in severe cases when outpatient care is insufficient to support proper growth.

Follow-Up and Monitoring

Regular follow-ups are essential to track progress and adjust interventions as needed. Parents and caregivers should work closely with healthcare professionals to ensure that their child is growing at a healthy rate.

With early intervention and appropriate support, most children with faltering growth can achieve normal development and thrive. 

History and Exam

Key diagnostic factors

  • presence of risk factors
  • faltering growth
  • signs of malnutrition
  • poor social history

Other diagnostic factors

  • family history of faltering growth
  • increased caloric loss
  • gastrointestinal symptoms
  • comorbid medical history

Risk factors

  • small for gestational age (SGA)
  • gastrointestinal problems (reflux, coeliac disease)
  • poor carer knowledge
  • poor carer-child interaction

Diagnostic Investigations

1st investigations to order

  • according to clinical assessment
  • FBC
  • iron studies
  • chemistry panel

Investigations to consider

  • blood lead level
  • serological testing for coeliac disease
  • stool analysis
  • HIV testing or other infectious screen

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    Other Related Conditions

    ASTHMA

    CONCERNS REGARDING GROWTH

    FEEDING PROBLEMS

    CONSTIPATION

    BED WETTING

    SEIZURES

    SLEEP DIFFICULTIES

    CHALLENGING BEHAVIOURS

    AUTISM SPECTRUM DISORDER

    LEARNING DIFFICULTIES

    ADHD & Oppositional behaviours

    LANGUAGE DISORDERS

    TICS & TOURETTES DISORDER

    ANXIETY

    DEPRESSION

    INFECTIONS

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com