NICE has published the draft guideline on ‘Faltering growth’ for consultation.
Faltering growth refers to a child not putting on weight as would normally be expected for their age and sex. Children with faltering growth may be identified by routine growth monitoring or by parental or health professional concern.
Newborn infants normally lose weight in the first days of life, but if the weight loss persists or is large, this can cause concern about whether effective feeding has been established. In older children, faltering growth can occur when nutritional intake doesn’t meet the child’s specific energy requirements.
The NICE draft guideline covers the recognition, assessment and monitoring of faltering growth in infants and children. It defines growth thresholds for concern, and identifies the risk factors for, and possible causes of, faltering growth. It also covers interventions, when to refer, and the information and support that should be given to parents or carers.
Draft recommendations include:
- Performing a clinical assessment, looking for signs of illness such as dehydration, and taking a detailed feeding history if infants in the early days of life lose more than 10% of their birth weight or they have not returned to their birth weight by 3 weeks of age.
- For infants and children where there are faltering growth concerns, provide community-based care with a ‘primary care team’ that includes a midwife, health visitor and GP.
The draft guideline can be found at: https://www.nice.org.uk/guidance/indevelopment/GID-CGWAVE0767/consultation/html-content.
The consultation runs from 18th April 2017 to 1st June 2017. The final guideline is expected to be published in October 2017.