Section G

Pattern growth -

Look at the weight-for-age curve for every 6-month category and put a tick mark to the appropriate pattern

	0-5 months	6-11 months	12-17 months	19-24 months
Presence of growth faltering (Inadequate weight gain, flattening or drop in weight)	G1.1	G1.2	G1.3	G1.4
Crossed from green into the	G2.1	G2.2	G2.3	G2.4
Crossed from orange into the red	G3.1	G3.2	G3.3	G3.4

Age of the child (in months) at the onset of any growth faltering (onset of inadequate weight gain / flattening /loss of weight)?

Months

Age of onset of any growth faltering verified by the field supervisor?

Months

Who detected the Growth faltering?

You or your husband
Family member
PHM
Medical Officer
Specialists (Pediatrician, neonatologist)
Other (Specify the person)

What were the actions taken by mother or care giver?

Improve feeding
Sought care from a health care provider
Gave vitamins
Gave food supplements
Other (Specify)

What were the actions taken by health staff?

Took a dietary history
Gave dietary advice
Increased number of weight or length checkups
Gave vitamin supplementation
Provided food supplementation (eg thriposha)
Referred for special advice
Other (Specify)

Ask possible reasons/ events that occurred at the onset of growth faltering

Introduction of complementary feeding
Illness of child
Illness of mother
Acute family situation (changing residence, family crisis like illness or death of a family member, another child born to the family, illness of another child)
Change in the principal caregiver (E.g., Mother going to work)
Started playgroup/ creche/ day care
Other (Specify)

What type of liquids or solid were given to the child during that time?

Type of action regarding feeding taken following the identification of growth faltering

Frequency of breast feeding was increased
Formula feeds were introduced
Complementary feeds were introduced
Complementary feeding improved
Thriposha
Other
None

If the child was referred to special advice to a hospital, did he or she was given BP 100?

Yes

Don't Know

Catch up growth: if growth faltering (inadequate weight gain, flattening or loss of weight) was noted, look for catch up growth after that

Complete (Returned to usual trajectory)
Incomplete (Rise is observed but not to usual trajectory)
No catch-up

If catch-up complete and returned to usual trajectory indicate the time taken in months

Months

Extract weight and length: to be obtained from the B portion of the CHDR held by the PHM (take photo)