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An evaluation of infants' growth in the Kingdom of Nepal
S Hosono1, M Okazaki, S Kagimoto
1Saitama Children's Medical Center, Japan. hosonos@rb3.so-net.ne.jp
Insights
Growth monitoring in Nepalese children revealed significant delays in weight gain and hampered catch-up growth due to chronic undernutrition. Early intervention and health worker training on growth charts are crucial for improving child health outcomes.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- The His Majesty's Government/Japan International Cooperation Agency Primary Health Care Project aimed to improve health in Nepal.
- Growth monitoring is a fundamental tool for assessing child health and nutritional status.
Purpose of the Study:
- To evaluate infant growth patterns in the Bhaktapur district of Nepal.
- To identify causes of growth faltering and failure-to-thrive in Nepalese children.
Main Methods:
- Anthropometric indices measured in 759 children.
- Analysis using World Health Organization (WHO) growth charts and Japanese national growth standards (1990).
Main Results:
- Infants up to 4 months followed the 50th percentile, but 5-12 month olds showed delayed weight gain (3rd percentile).
- Children over 1 year had growth curves below the 3rd percentile, with no catch-up growth before age 5.
- Chronic undernutrition and poor nutritional balance were identified as primary barriers to catch-up growth.
Conclusions:
- This study highlights the critical need to analyze causes of growth faltering in Nepalese infants.
- Appropriate counseling on feeding and health practices is essential.
- Training Nepalese health workers to effectively use growth charts is a key component of integrated healthcare.
Background:
The His Majesty's Government/Japan International Cooperation Agency Primary Health Care Project began in April 1993 in collaboration with the Saitama Prefectural Government, for the purpose of improving the health status of the people in model districts of the Kingdom of Nepal. Growth monitoring is one of the basic methods that defines the health and nutritional status of children.
Methods:
Anthropometric indices were measured in 759 children in the Bhaktapur district. We used the World Health Organization prototype growth chart and national growth standard for Japanese children (1990) to analyze the growth data.
Results:
We found that the average bodyweight growth curve of children up to 4 months of age followed the 50th percentile reference curve. For children of 5-12 months of age, there was a delay in bodyweight gain and the growth curve reached the 3rd percentile curve. For children more than 1 year old, the growth curve moved below the third percentile curve. Catch-up growth did not occur before the children reached 5 years of age. The main causes of catch-up growth being hampered were chronic undernutrition and inadequate nutritional balance.
Conclusions:
As this was the first opportunity to evaluate infant growth in this district, the first important consequence of the results was to analyze the causes of growth faltering and failure-to-thrive in Nepalese children. Even more important, was the need to give appropriate counseling on improving feeding and other health-related practices, and the most important consequence of all was to instruct Nepalese health workers that utilizing the growth charts is an integral part of health care.