This paper describes the process by which our clinical service identif
ies and manages children in the population with differing levels of se
verity of Failure to Thrive (FTT), ranging from cases managed solely b
y their own Health Visitor (HV), through to those requiring registrati
on under child protection procedures or even removal into care. We out
line the theoretical principles, research evidence and clinical experi
ence that has informed the development of the service and discuss the
lessons learnt that could be applied elsewhere.