preventing growth

Overview

Growth concerns, also called 'failure to thrive' or 'growth faltering', happen when a child's weight and height are not increasing as expected for their age and gender. It is not a single disease, but a sign that a child may not be getting enough nutrition or may have an underlying health condition.

Growth concerns are fairly common, especially in the first few years of life. Many children have a temporary dip in growth, but with proper care most return to a healthy growth pattern.

It can affect babies, toddlers, and older children. Sometimes it appears after an illness, feeding difficulty, or a stressful event. It can happen in any family, regardless of income or background.

Symptoms

Common symptoms

• Slower than expected weight gain
• Being smaller than other children of the same age
• Delayed developmental milestones like sitting, crawling, or walking

Symptoms in children

• Lack of interest in feeding
• Tiredness or low energy
• Irritability during or after feeding
• Loose or foul-smelling stools

Symptoms in older adults

• Growth concerns in older adults are not the same as in children. This article focuses on child growth.

Causes

Main causes

• Not taking in enough calories or nutrients
• Digestive problems that affect how the body absorbs food
• Underlying medical conditions, such as heart or lung disease, thyroid problems, or genetic conditions
• Frequent infections or repeated illnesses
• Feeding difficulties, like a poor latch, tongue-tie, or food refusal

Risk factors

• Being born prematurely or with low birth weight
• Living in poverty or food insecurity
• Parental stress, depression, or mental health challenges
• A chronic illness in the child
• Inconsistent care or neglect

When to see a doctor

See a doctor urgently if:

• If your child is losing weight or has not gained weight in several months
• If your child shows signs of dehydration or persistent vomiting
• If you notice blood in your child's stool

Book a routine appointment if:

• If you are worried about your child's feeding or growth patterns
• At every well-child check-up, ask your doctor to plot your child's growth on a chart

Diagnosis

Doctors diagnose growth concerns by measuring your child's height, weight, and head size over time, and comparing them to standardized growth charts. They will also ask about feeding habits, health history, and family history.

Tests that may be done

• Measurements and plotting on growth charts
• Blood tests to check for anaemia, thyroid problems, or other conditions
• Urine tests
• Developmental assessments

What to expect at your appointment

Your doctor may ask you to feed your child in the clinic to observe how they eat and swallow. They may also refer you to a paediatrician or dietitian for a more thorough assessment.

Treatment

Treatment focuses on the underlying cause and helping your child catch up on growth. This usually involves a team approach with your family doctor, paediatrician, dietitian, and sometimes other specialists.

Self-care at home

• Offer nutritious foods at regular meal times
• Make mealtimes calm and positive
• Encourage self-feeding as your child grows
• Provide high-calorie, nutrient-rich snacks if advised by a healthcare professional

Medical treatments

Medical treatment depends on the underlying cause. Examples include treating a digestive condition, managing an infection, or prescribing supplements such as vitamins or minerals if a deficiency is confirmed. Never give your child supplements or appetite stimulants without your doctor's approval.

When is surgery considered?

Surgery is rarely needed for growth problems. It may be considered if a physical issue such as a tongue-tie is interfering with feeding, or if there is a structural problem in the digestive system.

Living with this condition

Your child's weight and height will be checked at appointments. Keep a diary of meals, snacks, and any symptoms. Be patient — catch-up growth takes time.

Lifestyle tips

• Eat meals together as a family when possible
• Limit distractions like screens during feeding
• Create a consistent sleep routine, as good sleep supports growth

Diet and exercise

Provide a variety of foods from all food groups: fruits, vegetables, grains, protein, and dairy. Encourage gentle physical activity appropriate for your child's age, but remember that gaining weight may be more important than burning extra calories.

Mental health and emotional wellbeing

Parents and children can both feel stressed or anxious about growth. It is normal to worry. Talking to a counsellor or a support group can help. If you ever feel overwhelmed, reach out to your doctor or a mental health service for support.

Prevention

Not always, but many growth concerns can be prevented or caught early. Good nutrition, regular check-ups, and a supportive home environment make a big difference.

Vaccines

Keeping your child up to date with routine vaccinations helps prevent illnesses that can disrupt growth.

Screening programmes

Growth monitoring through routine health visits is the main screening tool. You can also weigh and measure your child at home and note any changes.

Complications

If left untreated

• Delayed development
• Weak bones
• A weaker immune system
• In severe cases, hospital care
• Long-term undernutrition may affect brain development

Long-term outlook

Most children who receive early support and treatment go on to grow and develop well. Catching a growth problem early gives your child the best chance of a healthy future.

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