| Abstract: | To determine the socioeconomic variables in children with slow growth (failure to thrive), a case–control study was carried out in two economically deprived areas of Newcastle upon Tyne. Three hundred and six children, aged 12–24 months, registered at two health authority clinics, were studied by reviewing their growth charts. Sixty-three had poor growth (weight deviating downwards across two major centiles from the maximum centile attained at 4–8 weeks of age). Five children were excluded because of known organic disease. A matched control group of normally growing children was selected from the same clinics. Study children and controls were examined and their parents interviewed on a range of socioeconomic, health and interactional factors. A health visitor assessment and a record of social work contact was obtained. The slowly growing children differed significantly from controls in being lighter and shorter, while their mothers spent less on food, needed more help with the child, had a poorer home environment and expressed greater concern over their child's health. Four different patterns of poor growth were identified by inspection of the charts: early onset (before 6 months but sustained), late onset (after 6 months), temporary and recurrent. The ‘recurrent’ group was associated with parenting difficulties and the ‘late onset’ group with adverse socioeconomic factors. Slow growth patterns in children under 2 years may be used as a screening tool to identify ‘children in need’ and should be sought on a population basis. Those identified can then be assessed further to ascertain the area where underlying difficulties lie, for intervention to follow as appropriate. |
