Archives of Disease in Childhood, Vol 64, 1478-1482, Copyright © 1989 by Archives of Disease in Childhood.
Growth velocity and stunting in rural Nepal
AM Costello
Department of Paediatrics, University College and Middlesex School of Medicine, London.
In a community based study, height and weight increments of 441 Nepali
children aged 0-6 years were measured before harvest and six months later
and compared with centile standards derived from American children. Low
mean growth velocities for height were found only in children under 2 years
of age, and for weight during the first 18 months. The mean height for age
standard deviation score for the 12-23 months age group was already -2.8 at
first measurement. The effect of the initial thinness of the child on
subsequent height and weight velocity was reciprocal: thin children seemed
to catch up weight at the expense of height. These results suggest that
stunting is caused largely by a reduced growth velocity during the
nutrition dependent infantile phase of growth, with some additional
impairment and delay in onset of the early childhood phase of growth
hormone dependent growth, especially in thin children. Nutritional
interventions after the second year of life are unlikely to alter the
prevalence of linear growth retardation in poor communities. Growth
velocity may be more useful than static anthropometry to assess the impact
of such interventions.
