K1 · Slow growth
Actual Child and teen
Definition
Height or weight is below what is expected for age.- Poor nutrition
- chronic illness
- hormone problems
- neglect
- Below the growth chart
- thin
- short
- poor appetite
📋 Scenario
A toddler's weight falls below the expected curve.
Subjective (S): (Parent) "He's small for his age."
Objective (O): Weight below the 3rd percentile; thin; poor appetite; growth chart falling.
Assessment tools for this scenario: CP-CHILD Child & Teen Check CP-SAFE Safety & Falls Score CP-FLUID Fluid Balance & Nutrition Score
Validated scales to consider: PEWS, FLACC, Morse Fall Scale, MUST, fluid chart, glucose
**CarePath diagnosis:** Slow growth related to poor nutrition, as evidenced by below the growth chart and thin.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Measure growth. | Accurate height and weight plotted on a growth chart show the pattern and whether the child is catching up or falling further behind. |
| Make a feeding plan. | A practical feeding plan gives the family clear steps to raise calories and nutrients, which are the likely cause of poor growth. |
| Involve a dietitian. | A dietitian can tailor foods and calories to the child's needs and find barriers to eating that the family may not notice. |
| Treat the cause. | Poor growth can come from illness or hormone problems, so finding and treating the cause is needed for lasting improvement. |
| Follow up. | Follow-up lets the team check progress and change the plan, since growth is judged over time and not from one visit. |
**Expected outcomes**
- Within 3 months: weight gain follows the expected curve, family follows the feeding plan, causes assessed.
**Linking the data to the diagnosis**
The toddler's parent says, "He's small for his age." His weight is below the 3rd percentile, he is thin, has a poor appetite and his growth chart is falling. This fits slow growth because the measurements are already below what is expected for his age and are still dropping, so it is actual, not risk. The plan aims for weight gain to follow the expected curve within 3 months, for the family to follow the feeding plan and for the cause to be assessed, using regular measurement, a dietitian and treatment of any underlying problem.
CarePath diagnosis
Slow growth related to poor nutrition, as evidenced by below the growth chart and thin.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Measure growth. | Accurate height and weight plotted on a growth chart show the pattern and whether the child is catching up or falling further behind. |
| 2. Make a feeding plan. | A practical feeding plan gives the family clear steps to raise calories and nutrients, which are the likely cause of poor growth. |
| 3. Involve a dietitian. | A dietitian can tailor foods and calories to the child's needs and find barriers to eating that the family may not notice. |
| 4. Treat the cause. | Poor growth can come from illness or hormone problems, so finding and treating the cause is needed for lasting improvement. |
| 5. Follow up. | Follow-up lets the team check progress and change the plan, since growth is judged over time and not from one visit. |
Expected outcomes
- Within 3 months: weight gain follows the expected curve, family follows the feeding plan, causes assessed.
Linking the data to the diagnosis
The toddler's parent says, "He's small for his age." His weight is below the 3rd percentile, he is thin, has a poor appetite and his growth chart is falling. This fits slow growth because the measurements are already below what is expected for his age and are still dropping, so it is actual, not risk. The plan aims for weight gain to follow the expected curve within 3 months, for the family to follow the feeding plan and for the cause to be assessed, using regular measurement, a dietitian and treatment of any underlying problem.