Kumar Praveen, Singh Preeti, Dewan Pooja, Shah Jayant, Basavaraja G V, Prabhu Sanjay, Seth Anju, Basu Srikanta, Singh Jai, Parikh Yogesh N, Irani Simin, Bedi Nidhi, Gaur Ajay, Elizabeth K E, Chandra Jagdish, Rawat Ashok Kumar, Gupta Piyush, Khalatkar Vasant M
Department of Pediatrics, Lady Hardinge Medical College & Associated Kalawati Saran Children'S Hospital, New Delhi, India.
University College of Medical Sciences & GTB Hospital, New Delhi, Delhi, India.
Indian Pediatr. 2025 May;62(5):329-346. doi: 10.1007/s13312-025-00060-2. Epub 2025 Apr 11.
To develop evidence-based guidelines for the prevention, identification, and management of growth failure in infants under 6 months (U6M), ensuring early detection and intervention to improve health outcomes.
Growth failure in the first 6 months of life significantly increases the risk of acute malnutrition and stunting in later childhood. Unlike older children, management in this age group prioritizes establishing exclusive breastfeeding and addressing feeding challenges. There are no standardized guidelines for identifying and managing growth failure in this vulnerable population.
A national consultative committee of experts was convened to formulate these guidelines. The committee conducted extensive discussions, dividing key areas among six working groups. The process included four virtual and one in-person meeting between August and October 2024. A draft guideline was developed, reviewed, and approved by all committee members.
Early growth failure is a significant public health concern. Timely identification of at-risk infants through mother-infant dyad assessments during routine health visits is essential. Weight-for-age is the most reliable anthropometric indicator for recognizing at-risk infants U6M. The term "infant at risk of poor growth and development" is recommended to identify at-risk infants needing intensified support. Community-based interventions should support at-risk infants without medical complications, while those with complications need facility-based care with skilled lactation support. Severely wasted infants require close monitoring for hypothermia, hypoglycemia, and sepsis. Establishing exclusive breastfeeding should be prioritized in all cases, and when not feasible, F-100D (Catch-up D) should be used to ensure safe nutritional rehabilitation while minimizing renal solute load.
制定基于证据的6个月以下婴儿生长发育迟缓预防、识别及管理指南，确保早期发现并干预，以改善健康结局。
出生后头6个月内的生长发育迟缓会显著增加儿童期后期急性营养不良和发育迟缓的风险。与大龄儿童不同，该年龄组的管理重点是建立纯母乳喂养并解决喂养难题。目前尚无针对这一脆弱人群生长发育迟缓识别与管理的标准化指南。
召集了一个全国专家咨询委员会来制定这些指南。该委员会进行了广泛讨论，将关键领域划分给六个工作组。该过程包括2024年8月至10月期间的四次线上会议和一次线下会议。制定了一份指南草案，并经所有委员会成员审查和批准。
早期生长发育迟缓是一个重大的公共卫生问题。在常规健康检查期间通过母婴二元评估及时识别高危婴儿至关重要。年龄别体重是识别6个月以下高危婴儿最可靠的人体测量指标。建议使用“生长发育不良风险婴儿”这一术语来识别需要强化支持的高危婴儿。基于社区的干预措施应支持无医学并发症的高危婴儿，而有并发症的婴儿则需要在具备熟练泌乳支持的医疗机构接受护理。严重消瘦的婴儿需要密切监测体温过低、低血糖和败血症情况。在所有情况下都应优先建立纯母乳喂养，若不可行，则应使用F-100D（追赶型奶粉）以确保安全的营养康复，同时尽量减少肾脏溶质负荷。
