Terminology and the trouble with "failure-to-thrive"

For too long the term “Failure-to-thrive” has been used to describe a situation when a child, generally a young infant has gained weight at a rate below that of their aged matched peers.

A “diagnosis” of failure to thrive is communicated to parents and the term becomes documented within medical notes and headlines referrals. For parents, the term can invoke emotions of distress with the resignation of the definition of failure.

Failure: the neglect or omission of expected or required action

For the child, the term fails to give credit to the fluidity of the situation. A condition that alone is not a disease nor disorder but rather a situation of lower than expected weight gain. Whilst the child is generally too young to understand the situation at the time, often medical records years later will highlight a period of “failure” during their younger days which can trigger scepticism of previous cares and their adequacy within the world.

We know that infant feeding and consequent growth can be a highly emotive aspect of parenting. Health Professionals have a key role in supporting parents during all stages of parenting including periods of suboptimal growth. This support should be inclusive of the avoidance of unnecessary guilt or anxiety about infant weight gain.

As Health Professionals we must move towards a more accurate diagnosis of situations of suboptimal weight gains. We must continue to screen, assess, intervene and monitor when situations of suboptimal growth present however we must shift to a change in practice from the use of the term “failure to thrive”. Suboptimal growth or Growth Faltering provides an accurate and less emotive definition of the situation. By definition, faltering describes the situation of a loss in strength or momentum. It is suggestive of a state of change and a state of fluidity. For the good of those we care for, let’s drop the “failure” and its associated emotions and shift our practice to “faltering” and its associated emotions of change.

Faltering: a situation of a loss in strength or momentum.

We support infants and children, together with their families during times of suboptimal growth.  We help parents and carers to understand adequate and appropriate growth for their child and support them during difficult feeding and growth periods. Contact us today to find out how we can help your family.