We have been working on performance improvement of the local government program. A recent workshop highlighted amongst many gaps that Growth monitoring rates are low and that Growth monitoring often does not lead to growth promotion. There is no clarity on 1. When do we consider a child has growth faltering? Literature from UK are very complicated. I am looking for simple cutoffs - like not gaining weight for three months in a row - that can be handled by community workers, with or without growth curves 2. Protocols for referring such children and what should the referral health personnel do. I would like to hear field experiences and tested protocols in third world situations.