Faltering growth

Anticipatory guidance can be given to parents on children’s changing nutritional needs and feeding patterns.[24]US Department of Health and Human Services. Dietary guidelines for Americans, 2020-2025. Oct 2022 [internet publication]. https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials ​​ These include:

• Exclusive breastfeeding for the first 6 months. Education of family members to support weaning to solids and nutrition in later infancy in term-born infants.

• If exclusive breastfeeding is not possible, formula feeding with iron-fortified infant formula for the first 6 months.

• When infants can sit, feeding in high chair with tray (or supported booster seat) to provide postural support and facilitate self-feeding.

• Eating with infants to model eating and facilitate trying new foods

• Not forcing, bribing, or tricking infants into eating.

Healthcare professionals should track weight-for-age, length-for-age, weight-for-length, and head circumference of the child (until age 2).[25]Bhutta ZA, Akseer N, Keats EC, et al. How countries can reduce child stunting at scale: lessons from exemplar countries. Am J Clin Nutr. 2020 Sep;112(suppl 2):894S-904S. https://www.sciencedirect.com/science/article/pii/S0002916522009625?via%3Dihub http://www.ncbi.nlm.nih.gov/pubmed/32692800?tool=bestpractice.com

There are steps that health professionals should take to prevent faltering growth, especially in high-risk families:

• Monitor growth

• Promote responsive feeding and children’s changing nutritional needs and feeding behaviour

• Monitor feeding/eating problems

• Help ensure adequate supply of food. The family may be eligible for food programmes