Failure to thrive refers to poor physical growth and development in a child. Faltering growth is defined in the 2017 NICE guidelines on faltering growth in children as a fall in weight across:

• One or more centile spaces if their birthweight was below the 9th centile
• Two or more centile spaces if their birthweight was between the 9th and 91st centile
• Three or more centile spaces if their birthweight was above the 91st centile

Causes

Anything that leads to inadequate energy and nutrition can lead to failure to thrive. Can be categorised as:

• Difficulty feeding
• Inadequate nutritional intake
• Malabsorption
• Inability to process nutrition
• Increased energy requirements

Assessment

Aim - To establish cause of failure to thrive

Areas to assess:

• Pregnancy, birth, developmental and social history
• Feeding or eating history
• Observe feeding
• Mums physical and mental health