Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Nutritional treatment of infants and children with faltering growth

European Journal of Clinical Nutrition volume 64, pages S11–S13 (2010)Cite this article

Subjects

Faltering growth can occur at any stage in children from birth to adolescence, although the younger the child the shorter the time before adverse effects occur. In treating children, there is the advantage that weight alone need not be used to complete an assessment: height, velocity and head circumference are also available. Height can be used until adult stature is achieved; head circumference is most useful during the first 2 years postnatally, but can still sometimes be useful after this period, as catch-up head growth can occasionally continue to occur. It is essential to ensure that accurate measurements are taken at appropriate time intervals and plotted with care on growth charts. When measurements are carried out too frequently, inappropriate referral can result as health professionals respond to normal variations in growth velocity. If measurements are carried out too infrequently, growth faltering may not be picked up until it is quite advanced, leading to avoidable morbidity for the child. Occasionally height and weight may appear normal, giving a body mass index within normal ranges despite the child having an abnormal body composition.

In this paper, faltering growth will be briefly reviewed both in infancy and in childhood, taking children with neurological impairment, those with cardiac conditions and those with neuromuscular disorders as examples. The role of balanced macro- and micro-nutrient input will be examined along with the need to rectify individual nutrient deficiencies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  • Barton JS, Hindmarsh PC, Scrimgeour CM, Rennie MJ, Preece MA (1994). Energy expenditure in congenital heart disease. Arch Dis Child 70, 5–9.

    Article  CAS  Google Scholar 

  • Bhutta ZA (2008). Micronutrient needs of malnourished children. Curr Opin Clin Nutr Metab Care 11, 309–314.

    Article  Google Scholar 

  • Clarke SE, Evans S, Macdonald A, Davies P, Booth IW (2007). Randomized comparison of a nutrient-dense formula with an energy-supplemented formula for infants with faltering growth. J Hum Nutr Diet 20, 329–339.

    Article  CAS  Google Scholar 

  • Daly A, Johnson T, MacDonald A (2004). Is fibre supplementation in paediatric sip feeds beneficial? J Hum Nutr Diet 17, 365–370.

    Article  CAS  Google Scholar 

  • Elia M, Engfer MB, Green CJ, Silk DB (2007). Systematic review and meta-analysis: the clinical and physiological effects of fibre-containing enteral formulae. Aliment Pharmacol Ther 27, 120–145.

    Article  Google Scholar 

  • Fjeld CR, Schoeller DA, Brown KH (1989). Body composition of children recovering from severe protein-energy malnutrition at two rates of catch-up growth. Am J Clin Nutr 50, 1266–1275.

    Article  CAS  Google Scholar 

  • Geukers VG, Oudshoorn JH, Taminiau JA, van der Ent CK, Schilte P, Ruiter AF et al. (2005). Short-term protein intake and stimulation of protein synthesis in stunted children with cystic fibrosis. Am J Clin Nutr 81, 605–610.

    Article  CAS  Google Scholar 

  • Jadcherla SR, Vijayapal AS, Leuthner S (2009). Feeding abilities in neonates with congenital heart disease: a retrospective study. J Perinatol 29, 112–118.

    Article  CAS  Google Scholar 

  • Nevin-Folino N (ed.) (2003). Pediatric Manual of Clinical Dietetics, 2nd edn. American Dietetic Association: USA.

    Google Scholar 

  • Philpot J, Bagnall A, King C, Dubowitz V, Muntoni F (1999). Feeding problems in merosin deficient congenital muscular dystrophy. Arch Dis Child 80, 542–547.

    Article  CAS  Google Scholar 

  • Ramelli GP, Aloysius A, King C, Davis T, Muntoni F (2007). Gastrostomy placement in paediatric patients with neuromuscular disorders: indications and outcome. Dev Med Child Neurol 49, 367–371.

    Article  Google Scholar 

  • Report of a Joint WHO/FAO/UNU Expert Consultation (2007). Protein and Amino Acid Requirements in Human Nutrition. WHO Technical Report Series No. 935. World Health Organization: Geneva.

  • Rivera JA, Hotz C, González-Cossío T, Neufeld L, García-Guerra A (2003). The effect of micronutrient deficiencies on child growth: a review of results from community-based supplementation trials. J Nutr 133, 4010S–4020S.

    Article  CAS  Google Scholar 

  • Salmon AP, Finkel Y, Silove ED, Evans JA, De Giovanni JV, Wright JG et al. (1989). Sodium balance in infants with severe congestive heart failure. Lancet 8667, 875.

    Article  Google Scholar 

  • Smuts CM, Lombard CJ, Benadé AJ, Dhansay MA, Berger J, Hop le T et al. (2005). Efficacy of a foodlet-based multiple micronutrient supplement for preventing growth faltering, anemia, and micronutrient deficiency of infants: the four country IRIS trial pooled data analysis. J Nutr 135, 631S–638S.

    Article  CAS  Google Scholar 

  • Sonuga-Barke EJ, Beckett C, Kreppner J, Castle J, Colvert E, Stevens S et al. (2008). Is sub-nutrition necessary for a poor outcome following early institutional deprivation? Dev Med Child Neurol 50, 664–671.

    Article  Google Scholar 

  • Stewart L, Mckaig N, Dunlop C, Daly H, Almond S (2006). Dietetic Assessment and Monitoring of Children with Special Needs with Faltering Growth. The British Dietetic Association Specialist Paediatric Group. http://members.bda.uk.com/Downloads/Professional%20Consensus%20Statement%20June%202006%202.pdf.

    Google Scholar 

  • Trier E, Wells JCK, Thomas AG (1999). Effect of a multifibre supplemented paediatric enteral feed on gastrointestinal function. J Pediatr Gastroenterol Nutr 28, 595.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Imperial Health Care, Hammersmith Hospital, London, UK

    C King & T Davis

Authors
  1. C King
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C King.

Ethics declarations

Competing interests

C King has received lecture fees from Nutricia. T Davis declares no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

King, C., Davis, T. Nutritional treatment of infants and children with faltering growth. Eur J Clin Nutr 64 (Suppl 1), S11–S13 (2010). https://doi.org/10.1038/ejcn.2010.41

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2010.41

This article is cited by

Search

Advanced search

Quick links