Stunted growth

Stunted growth, also known as stunting, refers to impaired growth and development in children, which results in a lower than average height for the child's age. Stunted growth can develop due to a range of direct and indirect causes, often in the context of living in poverty and food insecurity. Causes include poor fetal growth in the womb (fetal growth restriction), unsafe sanitation, poor quality drinking water, childhood infections and diarrhea, malnutrition in the mother or the child. Stunting is largely irreversible if occurring in the first 1000 days from conception to two years of age. Stunting increases the risk of death during childhood. Affected children generally do not recover lost height, and once stunting occurs, its effects are often long-lasting. Stunted children may experience worse cognitive development and poorer health in adulthood. Among children under five years of age, the global stunting prevalence declined from 26.3% in 2012 to 22.3% in 2022 and 23.2 percent in 2024. It is projected that 19.5% of all children under five will be stunted in 2030. More than 85% of the world's stunted children live in Asia and Africa.

Signs and symptoms

Stunted growth in children has the following public health impacts:

Greater risk for illness and premature death Delayed cognitive development, and poor school performance Reduced intelligence quotient Future risk of obesity Women of shorter stature have a greater risk for complications during childbirth due to their smaller pelvis and are at risk of delivering a baby with low birth weight Stunted growth can be passed to the next generation, known as the "intergenerational cycle of malnutrition" Early-life stunting can also lead to long-term developmental challenges. If a child is stunted at the age of 2, they tend to have a higher risk of poor cognitive and educational achievement in life, with subsequent socioeconomic and intergenerational consequences. Stunting might also lead to reductions in schooling, decreased economic productivity, and poverty. Stunted children also display higher risk of developing chronic non-communicable conditions such as diabetes and obesity as adults. If a stunted child undergoes substantial weight gain after age 2, this can lead to obesity. This is believed to be caused by metabolic changes produced by chronic malnutrition that can produce metabolic imbalances if the individual is exposed to excessive or poor quality diets as an adult. The development of obesity can lead to a higher risk of developing other related non-communicable diseases such as hypertension, coronary heart disease, metabolic syndrome, and stroke. On a societal level, stunted individuals may have physical and/or cognitive delays, affecting their performance in their careers. Stunting can therefore limit economic development and productivity, and it has been estimated that it can affect a country's GDP by up to 3%. Stunting is prevalent in the Global South and has severe consequences, including increased risk of infections and death. The global percentage of stunted growth decreased from 33% to 22.3% between 2000 and 2022. The largest drop took place in Asia, from 37.1% in 2000 to 28.2% in 2012 and 22.3% in 2022. Despite global progress, the prevalence of child stunting was greater than 30% in 28 countries in 2022 (most of which are in sub-Saharan Africa).

Causes

Almost all stunting occurs within the 1,000-day period that spans from conception to a child's second birthday, which constitutes a window of opportunity for growth promotion. The recognition of prenatal factors underlines the intergenerational aspects of growth, and the need for early interventions. The three main causes of stunting in South Asia, and probably in most developing countries, are poor feeding practices, poor maternal nutrition, and poor sanitation. The leading risk factors for stunting are fetal growth restriction (birth weight below the 10th percentile) followed by unimproved sanitation and diarrhea. 22% of stunting cases can be attributed to environmental factors, while 14% to child nutrition. In addition, women's education, gender equality, the quantity and quality of foods available also play significant roles in stunting rates.

Feeding practices Inadequate complementary child feeding and a general lack of vital nutrients besides pure caloric intake are some causes of stunted growth. Children need to be fed diets that meet the minimum requirements in terms of frequency and diversity to prevent undernutrition. Exclusive breastfeeding is recommended for the first six months of life and nutritious food alongside breastfeeding for children aged six months to two years old. Prolonged exclusive breastfeeding is associated with undernutrition because breast milk alone is nutritionally insufficient for children over six months old. Breastfeeding for a long time with inadequate complementary feeding leads to growth failure due to insufficient nutrients, which are essential for childhood development. The relationship between undernutrition and prolonged duration of breastfeeding is mostly observed among children from poor households with uneducated parents, as they are more likely to continue breastfeeding without meeting the minimum dietary diversity requirement.

… excerpt ends here. Continue reading the full article.