Tuesday, 11 September 2012

Masterclass - Feeding Your Child With Faltering Growth

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It’s a bit of work, but nothing is impossible.  It’s heart aching for a mum when a health professional diagnoses your child with faltering growth, but do you know what this term really means?

Faltering growth is a medical term used to describe when an infant or child fails to grow along their ‘own percentile line’ on a growth chart.  As a result, the child's weight and height may cross two or more centile lines on their chart. 

For example, assume baby Amelie was born on the 25th centile as plotted on a girls growth chart.  A few months later, her weight dropped to the 9th to 25th centile.  She continued to grow along this line for the next two years.  Her height on a different centile line, continued to follow the same line through-out her childhood. 

Amelie may only be classified as faltering to grow or ‘failing to thrive’ if her weight drops from the 25th centile down to less than the 2nd centile.  Her height may or may not be following her own line on the growth chart.  There are a multitude of reasons why a child may struggle to grow at their expected rate, but this is not the purpose of today's post.  For more information on faltering growth, refer to this short article by Great Ormond Street Hospital for Children titled Faltering Growth.


Your dietitian or medical practitioner may prescribe high energy milks or special feeds to help your child grow.  Alongside these special milks, the use of high energy foods such as margarine, cooked breakfasts, high energy snacks and food fortification with oils and fats can promote weight gain for your little one.

Here are a few suggestions.


Toast - your child may only have a few bites but you can make every mouthful calorific by using more than one spread such as margarine AND jam AND peanutbutter AND chocolate spread and so on.

Cereal - consider using full cream milk and add sugar or honey to increase overall caloric content of the meal.

For a leisurely breakfast, offer pancakes or waffles with syrups, croissants or brioche.  Eat meals with your child to create a pleasant and social atmosphere around meal times.

Get into a routine and feed your child at the same time each day.  Allow 30 minutes for each meal and never 'force' your child to eat.  This will only increase your child's anxiety around meal times.  Instead, create a positive feeding environment whereby you encourage your child and reinforce positive behaviour i.e. when your child takes a bite or puts food into their mouth clap your hands or offer words of encouragement.

Add meat AND an extra protein into sandwiches such as cheese.
Use margarine or other high fat spreads AND other fillings for sandwiches.
For soups, consider adding a teaspoon of oil or cream.
Similarly, mix in a teaspoon of margarine or vegetable oil into hot meals to boost calories

As above and always offer dessert even if it is something simple like yoghurt, jelly or tinned fruit.  Every extra bite counts!

Snacks - carry snacks with you so that you have something on hand if your little one says that he/she is hungry.  Cereal bars, dried fruit, biscuits, pre-packaged slices of cake or crisps are easy to transport for the busy mum on the go.  At home, you could offer cheese and crackers, toast with spreads, mini sandwiches, flavoured milk, fruit drizzled in honey or syrups or anything that the little one will accept and enjoys eating.

These are only a few ideas for increasing energy intake for the little one needing the extra calories.  For recipe ideas that are milk, egg, wheat or soy free, refer to the section Collection of milk, egg, wheat or soy free recipes. 


  • Offer 3 meals and 2 - 3 snacks per day at the same time each day
  • Allow up to 30 minutes for meal times
  • Never force your child to eat, encourage him or her to eat and reinforce positive behaviour with a hug or words of encouragement
  • Use two spreads on bread and choose at least 2 protein fillings in sandwiches to increase calorie intake
  • Consider adding a teaspoon of vegetable oil into a hot meal (mix this in prior to serving)
  • Offer dessert or a bed time snack 

This post has now been reposted on www.ukkidsnutrition.com

Good luck and do share any tips that you have found useful.  Please do comment below, I love hearing from you.