Poor growth (Failure to thrive)

Pre-referral guidelines for primary care providers

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.

Diagnosis

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.

Practice points

  • 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.

Referral pathways