NICE guidelines: children who don't gain weight

05 June 2017

The National Institute for Health and Care Excellence (NICE) has issued new draft guidelines for the care of children who do not gain weight as normally expected.


It recommends that children with ‘faltering growth’ should receive community-based care from a team that includes a midwife, a health visitor and a GP, and has access to professionals including an infant-feeding specialist.

The new guidelines state that normal weight loss usually stops when the baby is three or four days old, and most infants return to their birthweight by three weeks.

But where there are concerns, a clinical assessment should be performed, looking for signs of illness such as dehydration, and a detailed feeding history taken. Weight gain should be measured ‘at appropriate intervals, depending on the level of concern’.

NICE says an observation of feeding by an individual with ‘appropriate training and expertise’ should also be considered. 

The guidelines add: ‘Be aware that while supplementary feeding with infant formula in a breastfed infant may help with weight gain, it often results in cessation of breastfeeding.’

Referral to paediatric services should be considered if there is evidence of illness, marked weight loss, or failure to respond to interventions.

The consultation on the draft guidance ran until 1 June.
To read more, see