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Stunting trajectories from post-infancy to adolescence in Ethiopia, India, Peru, and Vietnam
Jewel Gausman1, Rockli Kim2, S V Subramanian3
1Women and Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Insights
Many children experience stunting, with some recovering while others develop it later in childhood. Interventions should support healthy growth throughout childhood, not just the first 1,000 days.
Area of Science:
- Childhood Growth and Development
- Nutritional Epidemiology
- Public Health Interventions
Background:
- Most interventions target the first 1,000 days to prevent stunting.
- A broader perspective on childhood growth trajectories is needed.
- Understanding stunting dynamics beyond infancy is crucial.
Purpose of the Study:
- To assess the prevalence of persistent stunting, recovery, and new stunting cases from birth to adolescence.
- To analyze childhood growth patterns beyond the critical first 1,000 days.
- To inform comprehensive child growth intervention strategies.
Main Methods:
- Longitudinal study of 7,128 children across Ethiopia, India, Peru, and Vietnam.
- Data collected across five survey waves from ages 1 to 15 years.
- Descriptive and graphical analyses of stunting trajectories.
Main Results:
- On average, 29.6% were stunted by age 1, 12.9% by age 5.
- Children stunted by age 1 had higher persistent stunting rates at age 15 (40.7%) compared to those stunted by age 5 (32.3%).
- Significant proportions recovered but later faltered (33.7% and 31.1%), and new stunting emerged between ages 8-15 (13.1%).
Conclusions:
- Childhood stunting is dynamic, with both onset and recovery occurring into adolescence.
- Interventions focused solely on the first 1,000 days may be insufficient.
- Long-term, holistic approaches are necessary to support healthy child growth.
Abstract:
Many interventions focus on preventing stunting in the first 1,000 days of life. We take a broader perspective on childhood growth to assess the proportions of children who suffer persistent stunting, recover, and falter and become newly stunted between birth and adolescence. We use longitudinal data collected on 7,128 children in Ethiopia, India, Peru, and Vietnam. Data were collected in five survey waves between the ages of 1 to 15 years. We use descriptive and graphical approaches to compare the trajectories of children first stunted by age 1, first stunted by age 5, and those remained not stunted until age 5. On average, 29.6% of children were first stunted by age 1, 12.9% of children were first stunted by the age 5, and 68.7% of children were not stunted at either age 1 or age 5. A larger percentage of children stunted by age 1 remained stunted at age 15 (40.7%) compared with those who were first stunted by age 5 (32.3%); 33.7% of children first stunted by age 1 and 31.1% of children first stunted by age 5 go on to recover, but then falter during later childhood. 13.1% of children who were not stunted at age 1 or age 5 become newly stunted between the ages of 8 and 15. Our results show that children both become stunted and recover from stunting into adolescence. More attention should be paid to interventions to support healthy growth throughout childhood.
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