Understanding Growth Faltering in Preterm Infants: A Parent’s Guide

Many parents of preterm infants may hear the term “growth faltering” and feel concerned. In simple terms, growth faltering means that a baby isn’t gaining weight or growing in length as quickly as expected. While it can sound alarming, it’s a recognized challenge that, with proper monitoring and nutritional support, can be effectively managed.

What Is Growth Faltering?

Doctors use specific guidelines to determine whether a child’s growth is on track. In general:

Underweight (or Wasting): When a child’s weight is more than 2 standard deviations (SD) below the average for their height.

Stunting (or Short Stature): When a child’s height is more than 2 SD below the average for their age.

Moderate vs. Severe Growth Faltering:

Moderate Acute Malnutrition: Weight-for-height falls between –2 SD and –3 SD from the mean.

Severe Acute Malnutrition: Weight-for-height is below –3 SD or certain arm measurements fall within a concerning range.

In everyday language, these measurements help doctors decide if your baby’s growth might need extra attention. Statistics in the United States show that mild to moderate growth faltering occurs in about 20% of children, while severe cases affect around 4%. These challenges can be seen across different backgrounds and continue into early childhood for some children.

Why Does Growth Faltering Occur?

For preterm infants, growth faltering is often related to missing out on the last few weeks of pregnancy when essential nutrients are transferred from the mother to the baby. This crucial period is when the fetus accumulates:

Calcium, Phosphorus, Magnesium, and Vitamin D: Vital for building strong bones and supporting overall growth.

Additionally, preterm infants might face challenges such as:

Reduced Physical Movement: In the womb, regular movement naturally stimulates bone and muscle development.

Increased Nutrient Needs: Once born, preterm babies work hard to catch up, often requiring higher amounts of energy and nutrients than full-term infants.

Other Contributing Factors: These can include difficulties with feeding (like breastfeeding challenges or issues with formula preparation), certain chronic conditions (heart or lung disease, chronic infections, or metabolic issues), and even environmental or psychosocial factors like parental stress or economic challenges.

How Do Healthcare Providers Monitor and Diagnose Growth Faltering?

Your baby’s healthcare team will carefully track growth using several methods:

Regular Check-Ups: Monitoring weight, length, and overall development.

Blood Tests: To check levels of calcium, phosphorus, and other markers that reflect nutrient absorption and overall health.

Imaging Techniques: Tools like ultrasound and X-rays may be used to assess bone development and look for early signs of conditions such as rickets.

Observation of Feeding: Sometimes, watching how a baby feeds can provide important clues about potential difficulties.

If no clear cause is found through history and physical exams, doctors might order a few screening tests to rule out issues like malabsorption or hidden infections. Remember, these evaluations help tailor the right approach to support your baby’s growth.

Supporting Healthy Growth Through Nutrition

The cornerstone of treating growth faltering is nutritional rehabilitation. Here’s how healthcare providers often approach this:

1. Initial Phase – Establishing a Nutritional Baseline:

• Provide 100% of the daily energy and protein requirements based on the baby’s current weight.

• Engage parents in education about feeding techniques, nutritional needs, and the importance of a supportive environment.

2. Catch-Up Phase – Increasing Nutritional Intake:

• Gradually increase calorie and nutrient intake to help the baby move toward an ideal weight.

• This might involve using fortified human milk, special formulas, or even adding extra calories through carbohydrates or healthy fats.

3. Maintenance Phase – Transitioning to Normal Feeding:

• Once the baby nears the ideal weight, nutrition is offered on an as-needed basis.

• Multivitamins and iron supplements are often added to support overall health during this period.

For example, a 6-month-old baby who isn’t gaining weight as expected might be given a modified formula with a higher caloric density. Simple adjustments—like mixing concentrated formula with less water—can make a significant difference in energy intake without overwhelming the baby’s digestive system.

A Positive Outlook for Your Little One

Although hearing about growth faltering can be worrying, it’s important to know that many preterm infants successfully overcome these early challenges. With diligent monitoring, personalized nutrition plans, and the expertise of your healthcare team, most children catch up with their peers and grow into healthy, active individuals.

Every baby is unique, and growth is influenced by a combination of factors including nutrition, overall health, and the environment. Open communication with your pediatrician is key—if you have any concerns about your baby’s growth, they can provide guidance tailored to your child’s specific needs.

Remember, early challenges in growth do not dictate long-term outcomes. With the right support and care, your little one can thrive, turning these early hurdles into stepping stones for a healthy future.

If you ever have questions or need reassurance about your baby’s growth, don’t hesitate to reach out to your healthcare team. They’re there to ensure that your child receives all the care necessary for a strong start in life.