New chart to evaluate weight faltering

Wright, Charlotte; Avery, Alison; Epstein, Melanie; Birks, Eileen; D, Croft

doi:10.1136/adc.78.1.40

Cited by 33 publications

(14 citation statements)

References 10 publications

(7 reference statements)

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“…Three centile spaces = 2 SD scores. From 6 weeks onwards, there is less variability, and only 5% of children will cross through two intercentile spaces between then and the age of 1 year,6and only 1% will cross three centile spaces 7. This guidance applies only to contemporary standards (UK 1990) because earlier standards show substantial variations compared with present weight gain patterns 8.…”

Section: Definitionmentioning

confidence: 99%

“…This guidance applies only to contemporary standards (UK 1990) because earlier standards show substantial variations compared with present weight gain patterns 8. An additional problem is that very large and small infants regress to the mean: 5% of children on the 98th centile will fall through three centile spaces, whereas only 1% of children on the 2nd centile will fall through two 7. If one does not allow for this, an excess number of large babies will be identified as having FTT, and very small children will be missed.…”

Section: Definitionmentioning

confidence: 99%

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Identification and management of failure to thrive: a community perspective

Wright

2000

Archives of Disease in Childhood

113

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Section: Definitionmentioning

confidence: 99%

Section: Definitionmentioning

confidence: 99%

Identification and management of failure to thrive: a community perspective

Wright

2000

Archives of Disease in Childhood

113

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“…For clinical purposes the adjustment has been incorporated into a specialist growth chart ( Fig. 1; Wright et al 1998a).…”

Section: The Definition Of Failure To Thrivementioning

confidence: 99%

Failure to thrive in a population context: two contrasting studies of feeding and nutritional status

2000

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Although failure to thrive (FTT) is generally thought to be a nutritional problem, dietary intake in children with FTT has been little researched. We describe two community-based studies of dietary intake and eating behaviour in FTT. The first study of ninety-seven children with FTT identified by population screening found that only a minority of case children were associated with neglect, organic illness or deprivation, even though dietary information suggested an underlying nutritional cause in the majority. Limited case-control data suggested significantly delayed weaning and less liking for food in general among the case children. The second study found diminished appetite, delayed progression onto solid foods and fewer foods eaten by forty-four children referred with FTT compared with forty-five controls, but was unable to detect a significant difference in energy intake, even allowing for varying body composition and other confounding variables. This study also revealed the bias introduced by recruiting case children by referral rather than screening, and that despite rigorous matching procedures the controls were not representative of the general population. These studies suggest a wide range of differences in eating behaviour and feeding patterns between children with FTT and controls, but suggest that measurements of nutrient totals may not be robust. Studies of FTT based on referred children can be misleading, as can comparison with controls, unless allowance can be made for important confounding social variables.

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“…has been explored, the extent to which health practitioners understand them and can use them 112 effectively is not clear. The layout and format of the chart may be important; a study in the 113 UK demonstrated that changing the chart format improved the precision of judgment made 114 about slow weight gain in infancy (Wright, Avery, Epstein, Birks, & Croft, 1998). 115…”

Section: Introduction 75mentioning

confidence: 99%

Health staff understanding, application, and interpretation of growth charts in Nigeria

Ezeofor

García

Ibeziako

et al. 2016

Maternal & Child Nutrition

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43We aimed to compare plotting accuracy and interpretation of weight gain patterns in average 44 and small infants on Road-to-Health (RTH) and the new WHO growth charts in Enugu, 45Nigeria. Child health staff plotted standard weights on both formats. Twelve plotted charts 46 were created, permutating 3 different weight trajectories (fast, steady, slow) ending at two 47 attained weights (average, small), with each plotted on both chart formats. Respondents 48 were shown four of these charts and asked to describe the weight gain pattern shown and 49 what action this pattern would prompt. There were 222 respondents, of whom 78% were 50 hospital-based; 54% were nurses, 32% medical doctors, and 13% nutritionists. Plotting 51 accuracy was good on both the WHO and RTH charts, but rating of weight gain was 52 generally poor. On the RTH chart, slow weight gain was correctly recognised in only 19% 53 average and 35% small infants and responses were not significantly associated with the 54 pattern shown. On the WHO charts, slow weight gain was correctly recognised in 40% 55 average and 65% small infants (p=0.002 and <0.001), but they were also more likely to rate 56 small children with normal growth as slow weight gain. In a logistic regression model, final 57 weight predicted a slow weight gain rating more strongly (OR=2.4; 1.8 to 3.2) than an actual 58 slow weight gain pattern (OR 1.8; 1.1 to 1.6). Health staff seemed unable to recognize slow 59 weight gain and were influenced more by current weight than actual weight gain pattern, 60 though the new WHO format improved recognition. 61 62

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New chart to evaluate weight faltering

Cited by 33 publications

References 10 publications

Identification and management of failure to thrive: a community perspective

Identification and management of failure to thrive: a community perspective

Failure to thrive in a population context: two contrasting studies of feeding and nutritional status

Health staff understanding, application, and interpretation of growth charts in Nigeria

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