Faltering growth
Are you concerned about your child's growth or has their growth been flagged by a healthcare professional? Our paediatric dietician can help look closely at your child's growth and give advice on how to boost their nutritional intake to be able to thrive.
What it is
Faltering growth is defined by NICE as crossing one or more weight centile lines downwards (depending on starting weight) or slow weight gain compared to expected. It is a sign, not a diagnosis. Causes are dominated by inadequate intake, feeding aversion, GORD, cow's milk protein allergy, coeliac disease and (less commonly) endocrine, renal, cardiac or genetic conditions.
Symptoms and signs
- Slow weight gain, weight crossing centiles downwards.
- Feeding difficulty, food refusal, prolonged feeds, recurrent vomiting.
- Loose stools, diarrhoea, constipation or visible undigested food.
- Parental concern about feeding behaviour, growth or development.
- Coexisting parental anxiety, postnatal mood difficulty — addressed alongside the child's assessment.
How we investigate
Detailed feeding history, growth-chart review, examination including hydration, growth parameters and developmental milestones. Bloods (FBC, ferritin, U&E, LFT, calcium, vitamin D, coeliac serology, IgE / specific IgE if allergy suspected, thyroid function), urine, stool calprotectin and microbiology where indicated.
Treatment options at The Vesey
- Feeding optimisation — practical, evidence-based feeding plans with our partner paediatric dietetics service.
- Cow's milk protein allergy management — extensively hydrolysed or amino-acid formulas, structured re-challenge.
- GORD management — feed thickeners, position, alginates, acid suppression where appropriate.
- Coeliac confirmation and gluten-free pathway.
- Onward referral — to gastroenterology, allergy, endocrinology or genetics where indicated.
- Parental support — including feeding behaviour, weaning and toddler-feeding workshops with our specialist team.
What is considered faltering growth in a child? +
NICE defines faltering growth as weight crossing one or more centile lines downwards, or a weight below the 2nd centile. Our dietitian assesses growth against individualised centile charts rather than using a single threshold.
How can I boost my child's calorie intake? +
We recommend food-first strategies: energy-dense foods, fortifying milk and meals, regular snacking, and reducing low-calorie drinks. We avoid prescribing appetite-supplement feeds before a proper dietary assessment.
Is faltering growth always a medical problem? +
Not always. Most cases have a nutritional or feeding-behaviour cause rather than an underlying medical condition. A structured assessment distinguishes the two and avoids unnecessary investigations.
What blood tests are done for faltering growth? +
We check for iron deficiency, coeliac disease, kidney function, liver enzymes, calcium, vitamin D and thyroid function. If allergy is suspected we add specific IgE testing. Stool samples may also be requested.
Pricing at a glance
Initial paediatric consultation £260 (60 min) · Paediatric blood panel from £190 · Paediatric dietetics from £180 · Follow-up reviews £190. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if you are worried about your child's feeding or growth, your child has crossed centiles downwards, or you have been told to "wait and see" without a clear plan.
Cost and pathway
Initial paediatric consultation £260 (60-minute slot). Paediatric blood panel from £190. Paediatric dietetics from £180. Follow-up reviews £190.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our paediatric team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
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Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727