Paediatric Nutrition and Growth Assessment
Specialist assessment of children with growth faltering, nutritional deficiencies, feeding difficulties, or obesity to identify underlying causes and implement evidence-based nutritional interventions.
Overview
Overview
Paediatric Nutrition and Growth Assessment is the specialist evaluation of children with growth faltering, nutritional deficiencies, feeding difficulties, extreme food selectivity, or childhood obesity to identify the underlying organic or behavioural causes and implement evidence-based nutritional interventions. Growth is the single most sensitive indicator of a child's overall nutritional and health status and serial weight and height measurements plotted on UK-WHO growth charts form the cornerstone of assessment. Early identification and treatment of organic causes of growth faltering — particularly coeliac disease, hypothyroidism, renal disease, and cardiac disease — prevents the significant cognitive and developmental consequences of prolonged childhood malnutrition.
Types of Paediatric Nutrition and Growth Assessment
- Faltering growth investigation — systematic clinical and laboratory evaluation of weight below the 2nd centile or downward centile crossing
- Feeding difficulty and food refusal assessment — evaluation of behavioural, oral motor, and sensory causes of food aversion and extreme selectivity
- Childhood obesity assessment and management — family-centred intervention addressing diet, physical activity, screen time, and the home food environment
- Food allergy nutritional assessment — ensuring dietary completeness and nutritional adequacy of strict allergen-avoidance diets
- Enteral nutrition support planning — nasogastric or gastrostomy tube feeding assessment for children unable to meet nutritional requirements orally
Risk Factors of Paediatric Nutrition and Growth Assessment
- Prematurity with ongoing feeding difficulties, increased post-discharge nutritional requirements, and catch-up growth monitoring needs
- Congenital heart disease increasing metabolic demands while simultaneously reducing the child's energy for effective feeding
- Coeliac disease causing malabsorption of calories, protein, iron, calcium, and fat-soluble vitamins from the damaged small intestine
- Hypothyroidism reducing metabolic rate and growth hormone axis responsiveness causing measurable growth retardation
- Chronic kidney disease causing anorexia, nutritional losses, and disturbed growth hormone metabolism leading to progressive growth faltering
- Autism spectrum disorder or sensory processing difficulties associated with extreme food selectivity limiting dietary variety and nutritional adequacy
Symptoms of Paediatric Nutrition and Growth Assessment
- Failure to regain birth weight by 2 weeks of age or slow weight gain in the first months of life suggesting inadequate milk intake
- Downward crossing of 2 or more centile lines on the weight growth chart requiring systematic investigation for organic causes
- Chronic diarrhoea, abdominal distension, and weight faltering suggesting coeliac disease, inflammatory bowel disease, or malabsorption
- Frequent vomiting after feeding and progressive weight loss suggesting gastro-oesophageal reflux or pyloric stenosis
- Extreme food selectivity accepting fewer than 20 different foods causing calorie, protein, and micronutrient inadequacy
- Prolonged mealtimes exceeding 30 minutes with significant gagging, choking, or distress suggesting oral motor dysfunction
- Pallor, fatigue, poor concentration, and brittle nails suggesting iron deficiency anaemia from an inadequate dietary intake
- Bowed legs, bone pain, dental enamel defects, and poor linear growth suggesting nutritional rickets from vitamin D and calcium deficiency
Key Benefits
Discover the advantages of choosing our paediatric nutrition and growth assessment services.
Early treatment of faltering growth prevents the cognitive and developmental consequences of malnutrition
Coeliac disease identification and gluten-free diet produces complete recovery of growth trajectory
Dietitian-led calorie fortification achieves weight gain without requiring larger food volumes
Mealtime behavioural strategies reduce food refusal and expand dietary variety
Organic cause identification ensures the correct treatment is directed at the underlying problem
Clinical Features
The technology, techniques and clinical approach behind our paediatric nutrition and growth assessment.
UK growth charts used with weight and height plotted at every appointment
Coeliac antibody testing performed for all children with unexplained faltering growth
3-day food diary reviewed with dietitian before any nutritional recommendations are made
6 to 8 week weight review intervals for all children with active growth faltering
Feeding therapy assessment for texture aversion and behavioural feeding difficulties
Preparation Instructions
Weigh and measure the child on the morning of the appointment if possible. Bring the red book with all previous weight and height measurements. Complete a 3-day food diary before the appointment. Bring any previous blood test results or specialist letters.
The Procedure
Step-by-step guide to what you can expect during your paediatric nutrition and growth assessment procedure.
Anthropometric Measurement and Centile Plotting
Height weight head circumference and BMI centile are measured and plotted on age-sex appropriate UK growth charts. Weight for height determines whether the child is wasted stunted or overweight -- directing the assessment pathway.
Dietary Assessment and Feeding History
A 3-day food diary is reviewed with parents quantifying calorie and protein intake. Feeding behaviour mealtime environment parental feeding practices food refusal patterns and texture tolerance are assessed systematically.
Investigation for Organic Causes of Faltering Growth
Blood tests screen for organic causes -- FBC and ferritin coeliac antibodies thyroid function renal function and calcium phosphate. Urine is tested for infection. Further investigation is guided by the clinical presentation.
Dietitian-Led Nutritional Intervention
For growth faltering the paediatric dietitian develops a high-calorie dense feeding plan using fortification of normal foods to increase calorie density without increasing food volume -- critical for appetite-restricted children.
Feeding Therapy for Behavioural Feeding Difficulties
Occupational therapy or speech and language therapy assessment is arranged for significant texture aversion gagging or sensory feeding difficulties. Behavioural feeding interventions address mealtime environment and systematic food exposure.
Growth Monitoring and Weight Review
Weight and height are reviewed at 6 to 8 week intervals for active growth faltering. Catch-up growth velocity confirms nutritional recovery. Absence of catch-up triggers re-investigation or intensification of nutritional support.
What to Expect
Height and weight are measured and plotted on centile charts. The paediatrician examines the child for signs of specific nutrient deficiency and underlying organic disease. Blood tests (FBC, coeliac screen, thyroid function, vitamin D, iron studies) are taken to exclude organic causes of growth faltering. Dietary intake is reviewed with the dietitian.
Recovery
Follow the personalised dietary recommendations from the dietitian. Attend all follow-up appointments as growth assessment requires serial measurements over time. Contact the team if weight loss accelerates or new symptoms develop.
Frequently Asked Questions
Common questions about paediatric nutrition and growth assessment.
Related Services
Explore other services in our Paediatrics department.
Neonatal Assessment and Care
Childhood Immunisation Programme
Paediatric Development Assessment
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