Assessing and managing the child with poor weight gain.

Healthy newborn babies grow and progress almost visibly on a dayto-day basis. Indeed, the rate of weight gain and growth is never again as rapid as in the first year of life, during which the average baby will have trebled its birth weight and grown by almost half of its length at birth. The first-contact health worker has to respond to a baby who is not growing at the expected rate, with enough knowledge and competence to be able to judge whether there is a problem, to identify babies who should be referred, and to give appropriate advice and to reassure mothers whose infants are growing at a slow but normal pace. Very frequently, the professional help of a nutritionist and feeding expert will be called in.