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It definitely felt less like a middle grade at times, with some brutal themes, but when I read it as a child I was okay with it so it depends on what your kids are fine with honestly and what you think they're ready for.
The writing was nice - slightly complex at times, but pretty and made it very easy to picture what was happening in my mind.
Graphic: Child abuse, Child death, Confinement, Death
Moderate: Animal cruelty, Animal death, Blood, Kidnapping, Alcohol
Minor: Drug use, Gun violence, Grief, Murder, War
Graphic: Animal death, Child death, Death, Emotional abuse, Physical abuse, Violence, Forced institutionalization, Xenophobia, Kidnapping, Grief, Religious bigotry, Medical trauma, Murder, Gaslighting, Abandonment, War, Injury/Injury detail, Classism
Moderate: Confinement, Drug use, Gore, Mental illness, Self harm, Toxic relationship, Blood, Alcohol
Moderate: Animal cruelty, Animal death, Child abuse, Child death, Death, Emotional abuse, Misogyny, Physical abuse, Violence, Medical content, Kidnapping, Medical trauma, Gaslighting
Minor: Drug use, Racial slurs, Racism, Sexism, Forced institutionalization, Xenophobia, Blood, Religious bigotry, Abandonment, Alcohol, Colonisation, Classism
Graphic: Animal death, Child abuse, Confinement, Violence, Blood, Kidnapping
Moderate: Child death, Drug use, Gore, Gun violence, Mental illness, Racism, Sexism, Religious bigotry
Minor: Slavery, Alcohol