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Primary Care Liaison

Failure to thrive

  • Initial work-up

    • Urinalysis
    • Stool MC&S
    • Stool for fat and fatty acid crystals
    • FBE with diff
    • LFTs
    • U&Es
    • Weight and height evaluation.
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    If gluten in diet,

    • Total IgA, Coeliac serology

    Recommended pre-referral treatment

    • If breast-fed baby, offer advice about technique
    • Involve MCHN or breast-feeding consultant - consider mastitis
    • Dietetic involvement for caloric supplement
    • Do not stop gluten

    When to refer

    • If getting adequate calories for growth and FTT is not explained by underlying disease, refer for further evaluation.
    • If there is abnormal coeliac serology, refer for further evaluation and a possible gastroscopy.

    Resources

    References and more reading

    • Paediatric Handbook (2009).ÌýGastrointestinal Conditions, Chapter 24 (pp369-389) Mark Oliver and Lionel Lubitz. Seventh Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia.

    GuidelineÌýdeveloped by the RCH Department of GastroenterologyÌýin consultation with a GP Review Group.ÌýMany thanksÌýto the GPs involved in the review.ÌýÌýFirst publishedÌýJan 2008.ÌýUpdated April 2010.
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