Faltering growth: recognition and management of faltering growth in children

NICE guideline Reference number:NG75 Published: 27 September 2017

Referral is indicated for an infant or child with faltering growth:

All of the above

If there are concerns about faltering growth monitor length or height at intervals in a child, but no more often than:

every 3 months

If there are concerns about faltering growth (and the threshold for centile changes have fallen), measure the weight at appropriate intervals, taking account of factors such as age and the level of concern, but usually no more often than:

daily if less than 1 month old.

If there are concerns about faltering growth (and the threshold for centile changes have fallen), measure the weight at appropriate intervals, taking account of factors such as age and the level of concern, but usually no more often than:

weekly between 1–6 months old.

If there are concerns about faltering growth (and the threshold for centile changes have fallen), measure the weight at appropriate intervals, taking account of factors such as age and the level of concern, but usually no more often than:

fortnightly between 6–12 months.

If there are concerns about faltering growth (and the threshold for centile changes have fallen), measure the weight at appropriate intervals, taking account of factors such as age and the level of concern, but usually no more often than:

monthly from 1 year of age.

If there are concerns about faltering growth (and the threshold for centile changes have fallen), measure the weight at appropriate intervals, taking account of factors such as age and the level of concern, but usually no more often than:

daily if less than 1 month old, weekly between 1–6 months old, fortnightly between 6–12 months, monthly from 1 year of age.

Only consider enteral tube feeding for infants and children with faltering growth when:

There are serious concerns about weight gain and an appropriate specialist multidisciplinary assessment for possible causes and contributory factors has been completed and other interventions have been tried without improvement.

Based on the feeding history and any direct observation of feeding, consider whether any of the following are contributing to faltering growth in milk-fed infants:

All the above

If there is concern about faltering growth: What do you need to consider investigating for the Assessment stage?

Urinary tract infection and Coeliac disease.

What do you need to consider for the Assessment stage apart from underline health conditions?

All the above