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Archives of Disease in Childhood - Education and Practice 2008;93:50-57; doi:10.1136/adc.2007.123943
Copyright © 2008 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health

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PROBLEM SOLVING IN CLINICAL PRACTICE

A fair reason for failing to thrive

K Connor, R Lennon, M E McGraw, R J M Coward

Bristol Royal Hospital for Children, Bristol, UK

Correspondence to:
Dr Richard Coward, Bristol Royal Hospital for Children, Paul O’Gorman Building, Upper Maudlin Street, Bristol BS2 8BJ, UK; Richard.Coward@bristol.ac.uk

The first 150 words of the full text of this article appear below.

Eva had an uncomplicated start to life. She was the third child of a fit and well 30-year-old mother, born by spontaneous vaginal delivery at 38 weeks with a birth weight of 2.77 kg (ninth centile). Exclusively breast fed, Eva’s growth was initially within normal range; however, at 5.5 months concern arose regarding her weight gain and after GP consultation, she was weaned in an attempt to increase her calorie intake. This made no difference and at 7 months of age, a specialist paediatric review was undertaken at her local hospital for ongoing faltering growth (fig 1).


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Figure 1 Eva’s growth chart during her first year.

 

COMMENT 1: FAILURE TO THRIVE






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