Failure to thrive has now been 'renamed' poor growth or faltering weight gain. Poor growth refers to a child who has crossed two percentile lines or is growing below the 1st percentile.
For the assessment and management of poor growth, please refer to the Royal Children’s Hospital clinical practice guidelines.
The diagnosis of poor growth or failure to thrive is a clinical one and cannot generally be determined from a single measurement, but rather plotting growth over time. Poor growth refers to a child who has crossed two percentile lines or is growing below the 1st percentile.
Underlying causes for poor growth must be considered, although the most common cause is non-organic (nutritional). See the RCH clinical practice guidelines for further information.
- Poor growth is common, and usually nutritional
- Serial measurements are required to determine poor growth, and can not be made on a single set of growth parameters.
- Using the WHO growth charts rather than the CDC charts will result in fewer false positive results, as they are more reflective of the present-day variation in our population’s growth.
- Paediatrician
- Referral to paediatric outpatient services can be considered for poor growth that is not responding to simple nutritional strategies, or more urgently if the child shows features suggestive of underlying organic disease or concerns regarding child abuse or neglect.
- Referral to paediatric outpatient services can be considered for poor growth that is not responding to simple nutritional strategies, or more urgently if the child shows features suggestive of underlying organic disease or concerns regarding child abuse or neglect.
- Dietetian
- Referral for dietetic services is often useful in management of poor growth not responsive to simple dietary modifications.
- Other resources