Helping children grow: a home-based intervention protocol.

Abstract

It is not uncommon for nurses in child health or Women, Infants, and Children Supplemental Food Program clinics to see children whose growth is at or below the 5th percentile on the National Center for Health Statistics (NCHS) growth grids, or whose growth has gradually dropped across the growth grids. These growth patterns may be from organic or nonorganic causes and are evidence of growth delay (when growth slows) or growth failure (when growth stalls); growth failure is also known as failure to thrive (Taitz & King, 1988). Many agencies and clinics define growth delay/failure as weight for age 2 percentile levels below height for age, or weight or height below the 5th percentile with birth weight above the 10th percentile (Hamill, Drizd, Johnson, Reed, & Roche, 1976). Weight for height should be proportionate even for preterm children. A child who is born preterm should be above the 5th percentile for weight and weight for length after his or her weight and length are age-adjusted. Preterm infants should have their weight age-adjusted until 24 months and their length age-adjusted until 40 months (Frank, 1995). Growth delay/failure is not an isolated phenomenon; it is present in one of six low-income Hispanic children, and one of seven low-income Black children (U.S. Department of Health and Human Services [USDHHS], 1991). The purpose of this article is to review the etiology of growth delay and failure, to discuss necessary components in the assessment of children with growth failure, and to present the effectiveness of a home-based intervention program.'