Faltering growth (failure to thrive) in children < 6 years

Paediatric Medicine (General Paediatrics)

Useful Management Information

  • If breast-fed baby, offer advice about technique – lactation consultant or child health nurse
  • Prematurity needs to be corrected on growth charts
  • Severe acute malnutrition is defined by more than 10% recent acute weight loss or crossing two major centiles or visible severe wasting or nutritional odema: WHO Growth Standards
  • Royal Children’s Melbourne Growth charts and calculators: RCH Growth Charts
  • If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?
Category 1 (appointment within 30 calendar days)
  • Infants < 1 year with faltering growth
  • Significant weight loss in a child up to 6 years
Category 2 (appointment within 90 calendar days)
  • Most other referrals with faltering growth in children < 6 years
Category 3 (appointment within 365 calendar days)
  • No category 3 criteria

If your patient does not meet the minimum referral criteria

  • Assessment and management information may be found on a range of conditions at HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Essential Referral Information

  • For infants less than 12 months must provide gestational age at birth (or weeks of prematurity)
  • Details of concern about growth
    • current height and weight, and include date of measurement
    • if under 2 years include head circumference

Additional Referral Information

Highly Desirable Information – may change triage category

  • Height/weight/head circumference/percentile charts (measured serially and plotted to note trend, if available). It is recommended that WHO growth standards be used for children under 2 years of age and CDC growth charts for children over 2 years of age
  • Feeding history:
    • infants – breast or formula, volumes or effectiveness of feeding
    • older children – feeding refusal, restrictive food choices
  • Gestational age at birth and birth weight
  • Bowel habit and any history of vomiting
  • GP impression of current developmental status (may be parental assessment) (= age appropriate, some delays, significant delays).
  • Family history (family history with short stature)
  • Social history
    • parental mental health problems
    • lack of financial resources for food requirement
    • lack of suitable housing
    • lack of family/community supports
    • refugee or recent immigrant background
    • failure to attend/engage hospital or community services appointments
    • previous history of child protection involvement

Desirable Information- Will assist at consultation

  • Other past medical history
  • Immunisation history
  • Medication history
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology

Investigations that may be considered with referral

  • Urinalysis
  • Stool PCR or M/C/S for infections, calprotectin, elastase
  • FBC with differential, LFTs U&Es TFT
  • If gluten in diet: coeliac serology, total IgA
Last updated 24 October 2021

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

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Send to: Gold Coast Health Service District

Internal Referrals

Paediatric Medicine (E-Blueslips)


(07) 5687 4497


Paediatric Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215


1300 744 284

Related HealthPathways

No directly related pathways found

Service Availability

Dr Susan Moloney


Gold Coast University Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Child Safety

If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, contact Department of Children, Youth Justice and Multicultural Services . Please consider if mandatory reporting applies.

Gold Coast Health - For Clinicians
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