Aims and intended learning outcomes This article aims to provide an overview of current scientific understanding of the role of nutrition in failure to thrive in early life. After reading this article you should be able to: ■Understand the way in which failure to thrive is detected and monitored ■Identify the health risks associated with failure to thrive in early life ■Appreciate the multifactorial causation of failure to thrive ■Appreciate that appropriate dietary advice is part of a broader approach to management ■Recognise that successful treatment can improve poor growth, rate of cognitive development and possibly longer term cognitive ability.