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"child growth"
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Mapping child growth failure across low- and middle-income countries
Childhood malnutrition is associated with high morbidity and mortality globally
1
. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood
2
. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0–59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards
3
–
5
. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age
z
-score, respectively, that is more than two standard deviations below the World Health Organization’s median growth reference standards for a healthy population
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. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)
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; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes
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. Building from our previous work mapping CGF in Africa
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, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live
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, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications.
High-resolution subnational mapping of child growth failure indicators for 105 low- and middle-income countries between 2000 and 2017 shows that, despite considerable progress, substantial geographical inequalities still exist in some countries.
Journal Article
Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes
To compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards ('the WHO standards') and the National Center for Health Statistics (NCHS)/WHO international growth reference ('the NCHS reference'), and discuss implications for child health programmes.
Secondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives.
Bangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe.
Respectively 4787, 10 381 and 226 infants and children.
Healthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%.
The WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations.
Journal Article
Welcome to your child's brain : how the mind grows from conception to college
\"How children think is one of the most enduring mysteries--and difficulties--of parenthood. The marketplace is full of gadgets and tools that claim to make your child smarter, happier, or learn languages faster, all built on the premise that manufacturers know something about your child's brain that you don't. These products are easy to sell, because good information about how children's minds really work is hard to come by. In their new book, neuroscientists Sandra Aamodt and Sam Wang separate fact from fiction about the inner workings of young minds. Martialing results from new studies and classic research, Aamodt and Wang provide the most complete answers out there on this subject. It liberates readers from superstitions and speculation, such as Freud's idea that all relationships are modeled on one's mother, or that it's not safe to eat sushi while pregnant. And it will reveal new truths about everything from how to make your baby sleep, to why we love to snuggle, to how children learn, forget, play, talk, walk, and feel. Welcome to Your Child's Brain is eye-opening and necessary, soon to become a staple for parents and children alike\"-- Provided by publisher.
Book
Adherence to Child Feeding Practices and Child Growth: A Retrospective Cohort Analysis in Cambodia
Appropriate feeding in the first 1000 days of a child’s life is critical for their health and growth. We determined associations between adherence to age-appropriate feeding practices and child growth in Cambodia. Children (n = 1079) were included in the first follow-up (FU) data analyses and followed for 30 months (six FUs). Data were analyzed by generalized linear mixed-effect models. Children who adhered to feeding practices on at least three FUs, with an adequate minimal dietary diversity (MDD), a minimal acceptable diet (MAD), and age-appropriate daily feeding (ADF) were less stunted (14.8%, 12.3%, and 6.4%, respectively) than children who never adhered to these indicators (25.2%, 30.1%, and 24.8%, respectively). A higher adherence to MDD and ADF was associated with a higher height-for-age Z-score (HAZ) (β: 0.13, 95% CI: 0.01–0.25 and β: 0.36, 95% CI: 0.22–0.50), while a higher adherence to the MDD and MAD was associated with a higher weight-for-height Z-score (WHZ) (β: 0.19, 95% CI: 0.08–0.30; and β: 0.16, 95% CI: 0.05–0.27). A higher adherence to a minimum meal frequency (MMF) was associated with a lower HAZ (β: −0.99, 95% CI: −1.28–−0.70). Our findings showed that to reduce wasting and stunting in Cambodia, interventions should focus on improving both the quality and quantity of food intake of children under two while targeting the whole complementary feeding period.
Journal Article
I love you forever
A young child asks its mommy, \"What age was I cutest of all? Now that I'm bigger or when I was small?\" Answered in a loving way that celebrates a mother's everlasting love for her child at any age.
Book
Putative Biomarkers of Environmental Enteric Disease Fail to Correlate in a Cross-Sectional Study in Two Study Sites in Sub-Saharan Africa
Environmental enteric dysfunction (EED) is an elusive, inflammatory syndrome of the small intestine thought to be associated with enterocyte loss and gut leakiness and lead to stunted child growth. To date, the gold standard for diagnosis is small intestine biopsy followed by histology. Several putative biomarkers for EED have been proposed and are widely used in the field. Here, we assessed in a cross-sectional study of children aged 2–5 years for a large set of biomarkers including markers of protein exudation (duodenal and fecal alpha-1-antitrypsin (AAT)), inflammation (duodenal and fecal calprotectin, duodenal, fecal and blood immunoglobulins, blood cytokines, C-reactive protein (CRP)), gut permeability (endocab, lactulose-mannitol ratio), enterocyte mass (citrulline) and general nutritional status (branched-chain amino acids (BCAA), insulin-like growth factor) in a group of 804 children in two Sub-Saharan countries. We correlated these markers with each other and with anemia in stunted and non-stunted children. AAT and calprotectin, CRP and citrulline and citrulline and BCAA correlated with each other. Furthermore, BCAA, citrulline, ferritin, fecal calprotectin and CRP levels were correlated with hemoglobin levels. Our results show that while several of the biomarkers are associated with anemia, there is little correlation between the different biomarkers. Better biomarkers and a better definition of EED are thus urgently needed.
Journal Article
I'll be there
A young boy and his mother talk about what she did for him as a baby, what he can do for himself now, and that she will always be there when he needs her.
Book
Micronutrient-rich food consumption, intra-household food allocation and child stunting in rural Nigeria
Children from rural households are often deprived of adequate micronutrient intakes either from food or supplementation. The present study examines: (i) the determinants of households' micronutrient-rich food consumption; and (ii) the combined effect of vitamin A supplementation and micronutrient-rich food consumption on child stunting in households with different food allocation patterns.
Cross-sectional study. Households' micronutrient-rich food consumption frequency and vitamin A supplementation were used as a proxy measure for child micronutrient intakes. Intra-household food allocation patterns were assessed from caregivers' perception of the disparity in food distribution within the household. Descriptive statistics and logistic regression were employed in analysing the study's objectives.
Rural communities in Kwara State, Nigeria.ParticipantsIncluded 419 children aged 6-59 months and 413 households.
Owning small livestock and a refrigerator, knowledge of micronutrient-rich foods and higher parental education had strong associations with households' micronutrient-rich food consumption. Children from households that consumed micronutrient-rich foods and received more diverse diets were less likely to experience stunting. The combined effect of micronutrient-rich food consumption and vitamin A supplementation was stronger on the likelihood of stunting reduction than the separate effect of each.
Assets ownership, human capital and knowledge of micronutrient-rich foods improve consumption of micronutrient-rich foods among the study population. Micronutrient supplementation to children with poor access to micronutrient-rich foods may not substantially enhance child growth unless reinforced through consumption of micronutrient-rich foods. Fruit and vegetable gardening, livestock holdings and nutrition education to parents should be integral parts of community nutrition programming.
Journal Article