[A health-oriented analytical reasoning approach in a child that fails to thrive].

An 11-month-old boy growing up in a vulnerable family environment is not thriving well. The youth healthcare physician provides nutritional advice and refers to a pediatrician. The pediatrician rules out physical causes, gives further nutritional advice, and refers to a dietitian, social worker, and eventually back to youth health care. We wonder whether this referral spiral and unnecessary healthcare costs could have been avoided by using a health-oriented analytical reasoning approach. The method of Health-oriented Analytical Reasoning results in a broad diagnosis that includes contextual factors and appropriate interventions. In this case, we would have focused on building trust with the family, improving nutrition, and reducing stress. There was sufficient reason not to refer to the pediatrician, as no clear signs of physical illness were present. Furthermore, this case highlights the importance of strong collaboration in child health care.