Determining if your child is meeting normal growth standards in the first two years may not be as obvious as you think.

A failure to thrive or growth faltering can have long-term consequences in children during their most critical periods of development.

“Growth trends are most important during the first two years of life and this coincides with the highest frequency of well-child visits for patients,” said Dr. Patrick McCann, a Marshfield Clinic Health System pediatrician. “It is important for parents to keep these appointments as growth parameters are assessed at each visit and allows for early intervention, if necessary. It is also very important for parents to keep an open dialogue with their care team if any concerns arise.”

Growth faltering is not a disease or disorder. Rather, it is a sign that a child is undernourished likely due to myriad reasons – lack of proper nutrition, access issues to obtain resources or inadequate intake of usable nutrition.

“Inadequate intake can also be due to a multitude of causes,” Dr. McCann said. “In the newborn period, this can be due to inadequate supply of breast milk or formula, improper mixing of formula, and improper feeding technique just to name a few. In later years, it can be due to food insecurity, ‘picky eaters,’ insufficient knowledge of appropriate diet by caregivers, and a host of other factors.”

Assessing growth at regular checkups critical

Growth faltering in the early months of development can be very deceiving to detect.

“Parents’ perception of growth is very subjective so growth faltering may go unnoticed,” Dr. McCann said. “It can be somewhat insidious in the early stages as development is usually preserved. If left unchecked, long-term ramifications can begin to show. That is why we monitor a patient’s height, weight, head circumference, and weight-for-length/height at each visit so that we can quickly intervene, if necessary.”

Assessing long-term risks

Children with poor weight gain are at increased risk of persistent short stature, cognitive deficits, secondary immunodeficiency, and increased risk of non-communicable diseases.

“This risk is incredibly important at all ages, but most important during the first two years of life,” Dr. McCann said.

Effective treatment plan is key

Because the causes vary so widely, it is essential that treatment plans are individualized and based on the reasons why the child has inadequate nutrition. Effective treatment, including potential referrals to specialists, often requires uncovering and addressing the causes in order to provide the best path to proper nourishment.

“At the very least, families can expect an increased frequency of visits for weight checks and diligent recording of nutritional intake,” Dr. McCann said.

To learn more about ensuring proper growth in your child, talk to your pediatrician.