Has recognition of failure to thrive changed?

Studies of failure to thrive often work to different definitions, and replication studies are rarely undertaken. A recent study completed in southern England encompassed an area previously studied some 5 years earlier. Although recognition of failure to thrive was not the focus of the focus of this work, the data are used to draw some conclusions regarding changes in recognition. There has been an improvement in recognition of children whose weight falls below the 3rd centile. Previously one in three of these children passed unrecognized as such by health professionals. Recent work indicates that now only one in five children below the 3rd centile are not recognized by health professionals as a cause for concern. However, in extending a definition of failure to thrive to include children whose growth deviated from an established growth curve for 3 consecutive months, crossing major centile lines, it was found that one in two of these children were not picked up by health professionals. The case is made for improved recognition of failure to thrive, and the implications of current patterns of child health surveillance, including moves to parent-held records are addressed.