Summary
Faltering growth, previously known as failure to thrive, describes a child’s weight, height, or body mass index (BMI) falling below expected levels for their age. It may also refer to a slower-than-expected growth rate.
This condition can occur in children of all socio-economic backgrounds but is more common in families facing multiple challenges, such as food insecurity or limited access to healthcare. Regardless of the cause, growth concerns can be stressful for families and may lead to anxiety and parent-child conflicts.
Diagnosis and When to Seek Help
Doctors diagnose faltering growth by carefully tracking a child’s growth over time, measuring weight, height (or length), and head circumference. They also assess:
- Nutritional intake – How much and what types of food a child consumes daily.
- Feeding environment – Family routines, meal consistency, and whether meals are provided in a nurturing setting.
- Medical history and physical examination – Looking for any underlying medical conditions.
Extensive medical tests are not always needed, but they may be performed if there are concerns about an underlying health issue.
If a child is not meeting growth expectations or shows signs of poor nutrition, early intervention is key. Seek medical advice if you notice:
- Significant or persistent weight loss or slow growth
- Feeding difficulties, such as refusal to eat or frequent vomiting
- Delayed developmental milestones
- Unusual lethargy, irritability, or persistent digestive issues
Management
Treatment for faltering growth depends on the underlying cause and often requires a team approach, involving medical professionals, nutritionists, psychologists, and social workers. Strategies may include:
- Nutritional support – Encouraging nutrient-rich meals and snacks tailored to the child’s needs.
- Parental guidance – Helping caregivers create structured, stress-free mealtime routines.
- Addressing underlying health conditions – If a medical issue is contributing to poor growth, targeted treatment may be needed.
Hospitalization is reserved for severe cases, such as when a child has significant weight loss, dehydration, or other medical complications.
Follow-Up and Monitoring
Regular check-ups are essential to track progress and adjust the management plan as needed. Families may also receive support from social workers or mental health professionals to address stress and anxiety related to feeding challenges.
Early recognition and intervention can significantly improve outcomes, ensuring a child reaches their full growth and developmental potential. If you have concerns about your child’s growth, consult a healthcare provider for personalized guidance.
History and Exam
Key diagnostic factor
- 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 factor
- 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
Book an Appointment
Other Related Conditions
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