GROWTH AND DEVELOPMENNT
Newborns almost always lose some weight in the first few days after birth. Most will lose between 5-
10% of birth weight and be back to birth weight by 10-14 days
In the first 2 weeks of life an infant should gain approx. 30g per day
Feeding pattern
Babies who breastfeed usually nurse for 10-30 mins at a time as often as every 2 hours
Bottle fed babies will take more per feed and less often
Urine output
5-6 wet nappies per day
Failure to thrive
Weight less than the 3rd centile on the growth chart
o Nb to plot patient on appropriate growth chart for gender, ethnicity and syndrome
o Downs and turners have their own chart
Inadequate input
Average infant needs
o 100kcals/kg/day
Range 80-140
Average child needs
o 40 – 90 kcals/kg/day
Adolescent needs
o 30 – 50kcal/kg/day
Regular formula and breast milk contain 20kcal/30mls
o So for infants needs = 120-210ml/kg/day
Aetiologies
Difficulty breast feeding
Improperly mixing formula
Neglect
Swallowing difficulty related to underlying neuropathology
Occult respiratory or cardiac issues
Increased metabolic demands
Aetiologies
Cerebral palsy
Congenital heart disease
Inflammatory disease
o Crohns
Renal disease
Malignancy
Too much out
Reflux
Cystic fibrosis
Differential
Diagnosis Comment
Congenital heart · Infants with some forms of congenital heart disease present with a
disease history of respiratory distress, difficulty feeding and poor weight gain (also
Congestive heart called failure to thrive).
Newborns almost always lose some weight in the first few days after birth. Most will lose between 5-
10% of birth weight and be back to birth weight by 10-14 days
In the first 2 weeks of life an infant should gain approx. 30g per day
Feeding pattern
Babies who breastfeed usually nurse for 10-30 mins at a time as often as every 2 hours
Bottle fed babies will take more per feed and less often
Urine output
5-6 wet nappies per day
Failure to thrive
Weight less than the 3rd centile on the growth chart
o Nb to plot patient on appropriate growth chart for gender, ethnicity and syndrome
o Downs and turners have their own chart
Inadequate input
Average infant needs
o 100kcals/kg/day
Range 80-140
Average child needs
o 40 – 90 kcals/kg/day
Adolescent needs
o 30 – 50kcal/kg/day
Regular formula and breast milk contain 20kcal/30mls
o So for infants needs = 120-210ml/kg/day
Aetiologies
Difficulty breast feeding
Improperly mixing formula
Neglect
Swallowing difficulty related to underlying neuropathology
Occult respiratory or cardiac issues
Increased metabolic demands
Aetiologies
Cerebral palsy
Congenital heart disease
Inflammatory disease
o Crohns
Renal disease
Malignancy
Too much out
Reflux
Cystic fibrosis
Differential
Diagnosis Comment
Congenital heart · Infants with some forms of congenital heart disease present with a
disease history of respiratory distress, difficulty feeding and poor weight gain (also
Congestive heart called failure to thrive).
