Signs of Failure to Thrive

A child may cross down on their growth pattern, gain weight slowly, or appear smaller than expected for their established pattern. Other clues include taking a very long time to feed, refusing textures, coughing during meals, frequent vomiting, loose stools or tiring before finishing. Some children have fewer wet nappies, less interest in play or slower progress with skills. A sign does not identify the cause by itself, and normal variation is common; clinicians look at change over time and the child’s overall health.

Book a child health review when concerns persist, and bring the child’s personal health record if available. Write down feeding times, approximate intake, vomiting, bowel changes, wet nappies, sleep and energy. Avoid comparing a child with siblings or pressuring them to eat. Offer suitable food calmly and continue the usual milk or formula advice until a clinician recommends a change. The assessment may include growth measurements, feeding observation, developmental review and targeted tests.

Seek prompt advice for ongoing poor intake, weight loss, repeated vomiting, persistent diarrhoea or a child who is becoming unusually quiet. Get urgent help if there is choking, difficult breathing, very little urine, signs of dehydration, severe weakness or difficulty waking. These warning signs need attention regardless of the child’s previous growth pattern.

Ask whether the growth trend is changing, which signs are most relevant, what information to track at home, and how quickly follow-up should occur.