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Journal Issue: Children and Poverty Volume 7 Number 2 Summer/Fall 1997

CHILD INDICATORS: Population-Based Growth Stunting
Eugene M. Lewit Nancy Kerrebrock

Causes of Growth Stunting

Inadequate nutrition is just one of several causes of growth stunting. Other contributors to stunting include chronic or recurrent infections, sometimes in combination with intestinal parasites. The prevalence of growth stunting, particularly among children under two years of age, can also reflect the prevalence of low birth weight in a population. Finally, in rare cases, growth stunting may reflect extreme psychosocial stress without nutritional deficiencies.7

The contributions of each of these causes to the growth stunting prevalence rate are only partly understood. One study concluded that from 20% to 40% of the prevalence of growth stunting in the first two years of life can be attributed to low birth weight.8 However, inadequate nutrition may still be implicated because some low weight births may be due to maternal nutritional deficiencies during pregnancy.9

Just as low birth weight and nutritional deficiencies are interrelated, so also are inadequate nutrition and the chronic or recurrent infections that are believed to contribute to growth stunting. There is evidence that even mild nutritional deficits can alter the immune response in children, before clinical signs of malnutrition occur, and that nutritional deficiencies during pregnancy can impair the infant's immune response after birth.10 Thus, the reasons for any given child's growth impairment may be complex. However, inadequate nutrition is a common theme that suggests a key focus for a policy response to the problem of growth stunting.