Pediatrics – The Grow Clinic

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The Grow Clinic for Children is an outpatient subspecialty clinic at Boston Medical Center that started in 1984 to provide comprehensive specialty medical, nutritional, developmental and social services and dietary assistance to children from the Greater Boston area referred with Failure To Thrive (FTT) by their primary care physician. In addition to providing clinical services, we advocate for policies that decrease the number of children in need. The Grow Clinic is part of BMC’s Department of Pediatrics.

About Failure to Thrive

Children with FTT have significant problems growing and do not gain weight or height at rates comparable to other children their age. Children who are not growing according to national standards are referred to the Grow Clinic by other clinics and physicians throughout the Greater Boston area for special care and follow-up.

Children with "Failure To Thrive" Diagnosis Demonstrate

• Shortened attention spans 
• Increased risk of illness 
• Persistent growth failure and emotional problems 
• Delayed learning and language skills
• Impaired fine and gross motor skills

About Our Patients

Since the clinic was founded in 1984, more than 1,650 FTT children have graduated from our program. In 2007, over 200 children were served in the clinic. The following are some of our findings:

• Average time of successful treatment is 18 months.

• The average new referral is much younger and more acutely ill than ever. During the period of January to the end of April 2008, there was a 20% increase in referrals for babies under the age of one compared to that same period of time in 2007.

• About 10% of our children are homeless and live in shelters.

• 85% of our children depend on public health insurance.

• The referral rate has doubled in the last five years.

• 10%-20% of children newly referred to the Grow Clinic were less than 2,500 grams at birth (low birth weight), and 89% of the children referred were less than 24 months of age.

Community Outreach

The Grow Clinic serves a diverse patient population, mostly low-income families from some of Greater Boston’s poorest communities, including Dorchester, Roxbury, Mattapan, Jamaica Plain, South Boston and the South End. Recent census data for these neighborhoods shows that:

• 68% of the population lives below 100% of the poverty level and nearly all live below 200% of the poverty level. 
  
  
•  55% of residents are African-American, 24% are Hispanic and 17% are Asian (includes Asian Indian and Middle Eastern). African Americans are at much higher risk of infant mortality than other ethnic groups, due in part to poor nutritional status of mothers and babies.

The Grow Clinic's intensive efforts to educate and reach out to community health centers have resulted in earlier intervention for FTT children, thus greatly increasing their chances of getting better and reducing the risk of hospitalization from 50% in 1984 to 5% in 2006.

The success of the clinic depends on outreach services that are not reimbursed by insurance companies or government programs. Therefore, the survival of the clinic depends on private donations to fund essential outreach services to our clients in addition to medical care.

The children in the Grow Clinic range from moderately to severely malnourished. Because malnutrition is both a medical problem and a social/economic condition, the clinic takes a multidisciplinary approach to the care of FTT children and their families. This approach recognizes that there is a relationship between a safe and secure family environment and the well-being of the child.

Children’s HealthWatch is the outreach and research arm of the Grow Clinic. Children’s HealthWatch identifies need for additional services for children in the pediatric emergency room with food insecurity and previously identified FTT and monitors the impact of public policy on the health of children ages zero to three.