Failure to thrive — MCCQE Part 1 MCQ

Correct answer: D — Correct feeding practice and assess for medical and social contributors

Correct feeding practice and assess for medical and social contributors is best because growth faltering requires nutritional, medical and social assessment. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Formula dilution can cause both undernutrition and electrolyte disturbance.

Reference: Canadian Paediatric Society growth monitoring guidance