‘Failure to thrive’ is a harmful and unhelpful term for my child

Within a few minutes of our fourth child’s birth, I noticed that he seemed small.

Born at full term, he was two inches smaller and a pound and a half lighter than his three older siblings. While I was concerned, all of his vital signs were good and our little one was fully alert. He was healthy, but on the smaller side.

He was as cute as a button.

A few days later, I called a lactation consultant in tears. Although I had successfully breastfed my older kids, this one seemed to have a painful latch and trouble completing a full feeding. I was exhausted, delirious and yet he was struggling to gain weight. With the help of an IBCLC, a nipple shield, the good nipple butter and a few painful nights, we finally transitioned to a better breastfeeding rhythm. Our baby finally started to gain weight, slowly, but he did continue to put on the ounces (not pounds).

By his one-year check in, our babe’s growth was growing more concerning. He had fallen off the growth charts. Despite our best efforts to give him high calorie foods, our little one tended to reach for fruits and vegetables at every meal. For most parents, healthy eating is a cause for celebration, but for a kid who struggles to gain weight, you long for them to love mashed potatoes with butter.

Given how little weight our son was gaining, we got referred to specialists, including pediatric gastroenterologists and nutritionists. I started googling and worrying about weird disorders. My nerves became frayed with every meal, hoping to keep my wiggly toddler still and interested enough to get a few hundred calories in him. We started supplementing with high calorie formula—feeding tube food, actually—aiming to add calories to his diet. But no specialists could find anything “wrong,” he was just growing at a slower rate than other kids.

And then came the doctors appointment when we got slapped with the label: “failure to thrive.” 

My happy, healthy toddler was deemed a “failure to thrive.”

It was a crushing blow after years spent trying everything to help him gain more weight.

To be clear: He was gaining weight and growing, just slowly and on a lower curve.

He is incredibly active and had a small appetite.

He seemed genetically smaller than other kids, but no less happy, intelligent or interactive than others.

But hearing that your child is “failing,” that YOU’RE “failing” after months of worrying and strategizing and focusing to help your child grow, it’s an unnecessary crushing blow.

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In fact, several doctors have directly addressed the medical label, trying to convince me that it doesn’t mean we are “failing.” So if the doctors say that the term is unhelpful, and parents find it insulting and shame-inducing, perhaps it’s time for another way to talk about my son’s condition.

Medical terms like “failure to thrive” are not helpful to parents.

“Failure to thrive” can never be a helpful term for families facing a scary, frustrating and tedious medical challenge. It causes unnecessary stress and shame. It makes me feel like I’m doing something wrong and like my child’s health is spiraling out of control. When the reality is, he’s healthy, hitting his milestones, and he is small for his age.

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I’m no scientific nomenclature expert, but I can think of a bunch of terms that would be more helpful, and less shame-inducing, than “failure to thrive.” To the medical providers reading this, feel free to use them:

Small stature 

Slow growth syndrome

Lower curve growth 

Growth restricted condition

Parenting is hard enough without medical terms that heap shame on families.

“Failure to thrive” kids aren’t failing at anything. 

A version of this story was originally published on July 19, 2022. It has been updated.