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Archives of Disease in Childhood 1999;80:500-506; doi:10.1136/adc.80.6.500
Copyright © 1999 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child 1999;80:500-506 ( June )

A randomised controlled trial of specialist health visitor intervention for failure to thrive

Pauline Raynora, Mary C J Rudolfa, Keith Cooperc, Paul Marchantc, David Cottrellb

a Community Paediatrics, Leeds Community and Mental Health Trust, Belmont House, 3-5 Belmont Grove, Leeds LS2 9NP, UK, b Academic Unit of Child and Adolescent Mental Health, School of Medicine, University of Leeds, Leeds LS2 8NS, UK, c Health Research Unit, School of Health Sciences, Leeds Metropolitan University, Leeds LS1 3HE, UK

Correspondence to: Dr Rudolf.

Accepted 17 December 1998

AIMS---To determine whether home intervention by a specialist health visitor affects the outcome of children with failure to thrive.
METHODS---Children referred for failure to thrive were randomised to receive conventional care, or conventional care and additional specialist home visiting for 12 months. Outcomes measured were growth, diet, use of health care resources, and Bayley, HAD (hospital anxiety and depression), and behavioural scales.
RESULTS---Eighty three children, aged 4-30 months, were enrolled, 42 received specialist health visitor intervention. Children in both groups showed good weight gain (mean (SD) increase in weight SD score for the specialist health visitor intervention group 0.59 (0.63) v 0.42 (0.62) for the control group). Children < 12 months in the intervention group showed a higher mean (SD) increase in weight SD score than the control group (0.82 (0.86) v 0.42 (0.79)). Both groups improved in developmental score and energy intake. No significant differences were found for the primary outcome measures, but controls had significantly more dietary referrals, social service involvement, and hospital admissions, and were less compliant with appointments.
CONCLUSIONS---The study failed to show that specialist health visitor intervention conferred additional benefits for the child. However, the specialist health visitor did provide a more coordinated approach, with significant savings in terms of health service use. Problems inherent to health service research are discussed.


Keywords: failure to thrive; health visitor; home visiting

© 1999 by Archives of Disease in Childhood
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