Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

NICE backs team-approach for faltering growth concerns

  • 1 Comment

Infants and children with “faltering growth” concerns should receive community-based care from a team that includes both a health visitor and a midwife, according to draft guidelines.

This “primary care team” should also include a GP and have access to professionals including an infant feeding specialist, said the Nation Institute for Health and Care Excellence.

“Measure their weight again at appropriate intervals depending on the level of concern”

NICE draft guideline

Faltering growth refers to a child not putting on weight as would normally be expected for their age and sex, noted NICE in its draft guidance on the condition, which was published today.

It stated that normal weight loss usually stopped after about three or four days of life, and most infants had returned to their birth weight by three weeks of age.

The institute highlighted that children with faltering growth may be identified by either routine growth monitoring or by parental or health professional concern.

Where there are concerns, a clinical assessment should be performed, looking for signs of illness such as dehydration, and a detailed feeding history taken if infants lose more than 10% of their birth weight or have not returned to their birth weight by three weeks of age.

NICE said that clinicians should also consider direct observation of feeding but ensure this was done by an individual with “appropriate training and expertise”, for example, in relation to breastfeeding and bottle feeding.

The guideline said: “If an infant loses more than 10% of their birth weight in the early days of life, measure their weight again at appropriate intervals depending on the level of concern, but usually no more frequently than daily.

“Be aware that while supplementary feeding with infant formula in a breastfed infant may help with weight gain, it often results in cessation of breastfeeding,” it added.

The guidance noted that a pathway of care should be in place for infants and children where there are concerns about faltering growth, with clarity on the role of community-based healthcare professionals and the process for referral to specialist care.

The draft guidance added that clinicians should consider referral to paediatric services if there was evidence of illness, marked weight loss, or failure to respond to interventions.

Overall, 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.

The consultation on the draft guidance runs from 18 April to 1 June. The final guideline is expected to be published in October 2017.

  • 1 Comment

Readers' comments (1)

  • Oh dear daily weighs!! Back to increasing unnecessary parental anxiety we already do holistic assessment in our area as an HV how baby handles responsiveness etc much more important than numbers on a scale. Breastfeeding can take up to 6 weeks to fully establish i do wonder sometimes whom devises these NICE guidelines those that practice or those whom have only theorised!

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.

Related Jobs