Patterns of Growth in Early Childhood and Infectious Disease and Nutritional Determinants
1Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Insights
Poor nutrition and infections in early childhood, especially in low- and middle-income countries, significantly hinder physical growth. Addressing maternal health, diet quality, and disease prevention is crucial for healthy child development.
Area of Science:
- Pediatrics
- Global Health
- Developmental Biology
Background:
- Child physical growth is significantly reduced in low- and middle-income countries compared to international standards.
- Growth deviations, particularly in the first two years, have severe consequences for child mortality, development, and long-term health.
- Intergenerational factors and prenatal conditions like maternal underweight and anemia contribute to fetal growth restriction and premature birth.
Purpose of the Study:
- To identify key determinants of growth faltering in young children.
- To understand the interplay of prenatal and postnatal factors affecting child growth.
- To highlight the critical role of early life nutrition and infection in growth outcomes.
Main Methods:
- The study synthesizes existing global data and research on child growth determinants.
- Analysis focuses on intergenerational, prenatal, and postnatal factors influencing physical growth.
- Investigates the impact of infectious diseases and dietary quality on growth faltering.
Main Results:
- Fetal growth restriction and premature birth account for a significant portion of stunting, especially in South Asia.
- Infectious diseases, including subclinical enteric infections, contribute substantially to growth faltering.
- Poor quality complementary feeding in infancy is a paramount factor in growth faltering.
Conclusions:
- Addressing maternal health, birth intervals, and prenatal conditions is essential to prevent early growth faltering.
- Improving postnatal nutrition and managing infectious diseases, particularly diarrhea, are critical for healthy child development.
- Integrated strategies targeting both prenatal and postnatal factors are necessary to improve child growth globally.
Abstract:
The physical growth of young children in low- and middle-income countries is reduced compared to international standards. The deviations in growth in both weight and height are greatest in the first 2 years of life and this has serious consequences for child mortality, development, adult stature, and health. The determinants of these patterns of growth faltering include intergenerational factors, such as maternal height, short birth interval, and conditions in pregnancy, including maternal underweight and anemia. These factors contribute to fetal growth restriction and premature delivery, which put many infants on a different growth trajectory. Postnatal exposure to microbes resulting in diarrhea and febrile infectious diseases and poor quality diet further compromise growth. Determinants of growth faltering after birth vary by setting and are not independent of each other. For example, the adverse effects of diarrhea on growth may be mitigated by a high-quality diet. Global estimates suggest that 25% of stunting can be attributed to fetal growth restriction and even more in countries in South Asia with a high prevalence of low birth weight. Infectious diseases may contribute a similar amount and subclinical enteric infections can result in intestinal dysfunction with adverse effects on nutrition and growth. Dietary factors, especially consumption of complementary foods of insufficient quality, have a paramount role in growth faltering in the critical period of infancy.
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