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GPs should encourage children to be 'messy with their food'

NICE has published advice for GPs on managing slow weight gain, or faltering growth, in infants and children.

The guideline is aimed at improving diagnosis, assessment and monitoring of children with faltering growth, helping GPs to jointly develop a management plan with the child's parents or carers, NICE said.

The final guidance suggests that parents should be advised to allow kids to be 'messy' with their food, as this may encourage them to eat.

It says GPs or health visitors should discuss with parents, where appropriate:

  • encouraging relaxed and enjoyable feeding and mealtimes;
  • eating together as a family or with other children;
  • encouraging young children to feed themselves;
  • allowing young children to be 'messy' with their food;
  • making sure feeds and mealtimes are not too brief or too long;
  • setting reasonable boundaries for mealtime behaviour while avoiding punitive approaches;
  • avoiding coercive feeding; and
  • establishing regular eating schedules (for example three meals and two snacks in a day).

It also outlines what GPs should do to identify underlying causes for faltering growth, which can be difficult to determine, and advises that if the condition persists, GPs should refer to a specialist service.

NICE said this comes as 1% of children aged four to five years were underweight in 2015, based on data collected in the National Child Measurement Programme.

When to refer to specialist services

If an infant or child with faltering growth has any of the following discuss with, or refer to, an appropriate paediatric specialist care service:

  • symptoms or signs that may indicate an underlying disorder;
  • a failure to respond to interventions delivered in a primary care setting;
  • slow linear growth or unexplained short stature;
  • rapid weight loss or severe undernutrition;
  • features that cause safeguarding concerns (see the NICE guideline on child maltreatment).

Source: NICE

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