Growth and inadequate weight gain

What growth charts show

Measurements are plotted on charts suitable for age and sex. A percentile describes the position of a measurement relative to the reference population; it is not a health grade, and not every child needs to be near the average. What matters is the child’s own course and the agreement between weight, length and other measurements.

A sudden change may also be a measurement error, so the data, the equipment and the way of measuring are confirmed. Gain in length and weight are examined together, because physical growth cannot be described fully by kilograms. Family history helps interpretation.

Why weight gain may slow

Causes include inadequate food intake, feeding difficulties, poor absorption or increased demands from illness. Several factors often interact. In an infant, latching, milk transfer, frequency of feeds and formula preparation are examined.

In an older child, drinks that reduce appetite, irregular meals, difficulties with textures or dietary restrictions may contribute. Persistent diarrhea, vomiting, infections and chronic illnesses change the direction of investigation. Family circumstances and access to food are assessed in order to offer support, without blaming parents.

What the assessment includes

Bring measurements from birth and describe what the child eats and drinks over a day. The pediatrician examines development, signs of illness and, when useful, observes a feed. A short diary of meals, vomiting and stools can help.

Tests are chosen according to findings. Urinary infection, celiac disease or other conditions may be considered when there is reason. In a child who is well and follows a stable course, extensive investigation may not be needed. A low weight alone does not diagnose a hormone deficiency.

Frequently asked questions from parents

Is it bad if my child has a low percentile? Not necessarily. A percentile describes position relative to the population, not health. A child who grows steadily at a low percentile, in good condition, is often perfectly normal. Attention is needed when the child crosses to another curve or growth stops.

How often should I weigh my child? The pediatrician decides the frequency. Frequent weighing without a plan makes interpretation harder, because weight varies from day to day. Measurements are compared at suitable intervals and with the same equipment.

Should I give vitamins for appetite? Not routinely. Vitamins and appetite stimulants do not solve the reason for reduced food intake and some may have side effects. The doctor assesses whether a deficiency is proven and decides whether a supplement is needed.

How should I feed a child who refuses to eat? Offer meals at regular times, in a calm atmosphere and without screens, with suitable portions. Do not force and do not use food as a reward or punishment. Limit sugary drinks and excess milk that take away appetite for meals.

When are tests needed? When the history or examination suggest a cause, for example persistent diarrhea, vomiting, recurrent infections, signs of celiac disease or an endocrine problem. In a healthy child with a stable course, extensive investigation is not needed.

Does genetics matter? Yes. The height and build of the parents influence the child’s growth. The pediatrician takes into account the parents’ height and the tempo of puberty in the family when interpreting the curves.

How the feeding plan is built

The plan may include support for breastfeeding, better organization of meals and foods of nutritional value suitable for age. Offer meals in a calm atmosphere and avoid forcing the child to eat. Changing the concentration of formula or using energy supplements should be done only with guidance.

Do not remove whole food groups because of a suspected allergy. If a particular illness is suspected, investigation and feeding are coordinated so that deficiencies are not added. Follow-up assesses tolerance of meals, development and growth rate. The frequency of measurements is set by the pediatrician; frequent weighing without a plan can make interpretation harder.

Care at Tirana Polyclinic: We offer pediatric consultation for interpreting growth and test results. When a gastrointestinal, endocrine or other cause is suspected, follow-up is coordinated with the relevant specialist and service.