Useful Management Information

  • Correct for prematurity (<37 weeks) until 24 months of age
  • A detailed history (personal, family & social), consider the following
    • antenatal complications and maternal health
    • birth weight, length and head circumference
    • significant intercurrent illnesses coinciding with onset of poor growth
    • vomiting and diarrhoea
    • developmental delay, regression or syndromal causes of poor growt
    • mid-parental height and the family history of childhood weight gain
    • lack of financial resources for food requirements
    • lack of suitable housing
    • lack of family/community supports
    • refugee or recent immigrant background
    • parental mental health problems
    • community services history – particularly failure to engage with MCH services and local GP
    • failure to attend hospital or community services appointments
    • previous history of child protection involvement
  • 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.
  • There are growth charts available for specific conditions including Down syndrome, Turner syndrome and Williams syndrome and these should be used
  • A clear follow up plan should be documented
  • The frequency of follow up depends on the child’s weight, age and psychosocial circumstances. Younger infants need more frequent follow up.
  • If follow-up appointments are not attended, immediate action should be taken to ascertain health status of the child. Refer to child protection if considered to be at risk.

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?
Category 1 (appointment within 30 calendar days)
  • Possible CNS signs (visual disturbance, morning headaches etc)
  • Hypoglycaemia
  • Untreated hypothyroidism
  • Cushing’s syndrome (not iatrogenic)
  • Signs and symptoms suggestive of IBD, renal failure other serious intercurrent illness or significant medical problems
  • Pubertal arrest
Category 2 (appointment within 90 calendar days)
  • Constitutional delay of growth and puberty
  • Delayed puberty >12y females and 13y males
  • Primary or secondary amenorrhoea
  • Small for gestational age with no catch-up growth
  • Abnormal coeliac serology
  • Hypothyroidism started on treatment
  • Syndrome associated short stature
  • Documented channel crossing due to poor height velocity
  • Iatrogenic Cushing’s syndrome
  • Skeletal dysplasias
  • Short stature with increased fracturing
  • Short stature with relative obesity
Category 3 (appointment within 365 calendar days)
  • If there is parental concern
  • Variants of normal growth including familial short stature

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

  • Serial measurements are needed to assess a child’s growth
  • A detailed history (personal, family & social)
  • Details of all treatments offered and efficacy
  • Physical examination
    • signs of neglect or abuse
  • Assessment of psychosocial deprivation
  • Development assessment
  • Feeding history

Additional Referral Information

  • Please include any other information you feel is relevant]
  • Accurate parental heights obtained
  • FBC ESR/CRP – to exclude anaemia and inflammation (pointers to further testing required
  • U&E – to exclude renal disease
  • Bone chemistry (calcium, phosphate and alkaline phosphatase) - to exclude malabsorption, bone disorders including rickets
  • Coeliac serology (TTG & IgA)
  • TSH & FT4 –to exclude hypothyroidism (peripheral or central)
  • IGF1 – to exclude GH deficiency
  • FSH in girls <2y or >9y - to exclude Turner syndrome –Karyotype between these ages
  • Urine protein & blood – to exclude renal disease
Last updated 7 October 2021

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

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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