Abstract
Weight gain is a sensitive indicator of health in infancy but there is no recognised point when a fall away becomes abnormal. We collected weights from an annual cohort of 3418 children, aged 18-30 months(m) and, by correlational methods, produced a measure of centile shift, the “Thrive Index”(TI). This is the deficit between a child's actual weight standard deviation score (SDS) and that predicted by their early weight, adjusted for regression to the mean. Only 5% children had a TI value of less than -1.26 SDS in the first 18m and this value can thus be used as a lower threshold of normality in the population.
We report the early findings of a screening programme using this method. 50 chil dren with subnormal TI values have been identified at a median age of 9.6m (2.6-20.4m), and followed up for a median of 9.2m (2.1-17.0m). At medical assessment at a median age of 13.4m, 13/50 had already recovered, but 24/50 now had a TI <-1.75, compared to 17/50 at the time of screen (p = 0.04 Chi2). Major organic disease was found in 2 and neglect in 6. Evidence of undernutrition was found in 29 children and advice offered. In the remainder no clear cause was uncovered, At early follow up 19/50 were now recovered and only 15/50 had a TI <-l.75 (p = 0.06 Chi2 trend). Bottle feeding, deprivation and undernutrition were significant predictors of non-recovery.
Our findings suggest that the Thrive Index may be useful both to identify a vulnerable group of children and to provide a quantifiable measure of their progress, at an age when other measures of longitudinal growth are impractical.
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Wright, C., Waterston, T. & Green, A. THE THRIVE INDEX: A METHOD OF IDENTIFYING AND QUANTIFYING ABNORMAL WEIGHT GAIN IN EARLY CHILDHOOD. Pediatr Res 35, 263 (1994). https://doi.org/10.1203/00006450-199402000-00051
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DOI: https://doi.org/10.1203/00006450-199402000-00051