Faltering Growth vs Failure to Thrive: What Solicitors & Parents Need to Know

Failure to thrive, a parent's worst nightmare

Few phrases cause more anxiety for parents than being told their child has “failure to thrive.” But what does it really mean?

And how does it differ from the term “faltering growth”?

As a paediatric dietitian and expert witness, I’ve seen confusion over terminology in both clinical practice and legal cases. Understanding the difference is essential for parents — and for solicitors handling negligence claims.

Faltering growth, if not managed can lead to children being hospitalised

Definitions of faltering growth vs failure to thrive

Faltering growth: Preferred UK term. Child’s weight/height crossing centile lines downwards on growth chart.

Failure to thrive (FTT): Older, non-specific term, still used in some records.

Key point: Both describe inadequate growth, but faltering growth is more precise and clinically accepted.

What does the clinical guidance say?

NICE CG75: Children with faltering growth should have comprehensive assessment.

Includes: dietary intake, feeding history, growth chart review, medical causes.

Early referral to paediatric dietitian is recommended.

Why Terminology Matters in Law

“Failure to thrive” is descriptive, not diagnostic.

“Faltering growth” links directly to growth chart data.

In negligence cases, the terminology used can influence interpretation of medical records and causation.

Case Example

A toddler’s records repeatedly noted “failure to thrive” but no referral to dietetics was made. The child was later found to have untreated coeliac disease and had dropped below the 0.4th centile.

In legal proceedings, failure to act on growth faltering was highlighted as a breach of duty.

Supporting Children Clinically

• Accurate measurement & charting.

• Comprehensive feeding assessment.

• Investigating underlying causes (GI disease, feeding disorder, neglect).

• Nutrition support tailored to age and diagnosis.

FAQs

Is faltering growth always neglect or negligence? No — many medical and feeding issues can cause it. Negligence is only relevant when clear standards of care are not met.

Can children catch up? Yes — with early intervention, catch-up growth is possible.

Why do courts care about the term used? Because it shapes how evidence is interpreted. “Failure to thrive” may appear vague, while “faltering growth” links to objective centile data.

Closing Thought

Words matter. For parents, clarity means less fear. For solicitors, accurate terminology can mean the difference between a weak case and a compelling one. For children, timely recognition and intervention mean a healthier future.