• Analysis of growth in 31 patients with the VATER association showed that 14 (45%) of these patients experienced postnatal growth deficiency (>−2 SDs) for at least the first three years of life or beyond. The other 17 patients (55%) had growth that fell within the normal range but which was usually less than the 50th percentile during at least the first three years of life. Severe cardiac defect was present in nine (64%) of the growth-deficient patients and was the only defect that was significantly correlated with growth deficiency. No explanation for the deficiency in growth in the other five children was found. When growth deficiency was present, it was of postnatal onset.