A range of factors that contribute to a child becoming stunted has been identified.
They include low socio-economic status, dietary intake, infections, the mother’s nutrition, micronutrient deficiencies and poor sanitation, the Global Childhood Report 2019 has stated.
Because of these varied challenges, stunting is a difficult problem to beat, the report, released November 30, stated.
The reports notes that nearly one in four children under age five worldwide has stunted growth, though global stunting prevalence has dropped from 32.5 percent in 2000 to 21.9 percent in 2018, and the number of stunted children fell from 198 million to 149 million.
“This translates to a 33 percent global decline in stunting. As a result, there were 49 million fewer stunted children in 2018 than in 2000,” the report stated.
While it noted that almost all the children saved from stunting live in Asia, the study states that in sub-Saharan Africa, stunting rates are stagnant or have risen in many countries, and the overall number of stunted children in Africa has increased from 50 million to 59 million.
Recent research by Save the Children found that in 2030 – the deadline for the Sustainable Development Goal to end hunger in all its forms – 119 million children will still find their physical and cognitive development stunted by malnutrition, with the poorest children at highest risk.
Speaking with our correspondent, Registered Dietitian-Nutritionist at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nwabumma Asouzu, says stunting affects children’s health by making them more susceptible to diseases and infections.
According to the dietician, stunted children who experience rapid weight gain after the age of two years have an increased risk of becoming overweight or obese later in life, revealing that such weight gain is also associated with a higher risk of coronary heart disease, stroke, hypertension and type 2 diabetes.
Asouzu said stunting is a major contributor to child morbidity and mortality.
Reeling out the effects of stunting, she said, “Stunting not only affects a child’s health, making them more susceptible to disease and infection, but it also impairs their mental and physical development – meaning children who suffer from stunting are less likely to achieve their full height and cognitive potentials as adults.”
Continuing, she said, “Stunted children who experience rapid weight gain after the age of two have an increased risk of becoming overweight or obese later in life. Such weight gain is also associated with a higher risk of coronary heart disease, stroke, hypertension and type 2 diabetes.
“Stunting is an enormous drain on economic productivity and growth.”
In worse case scenarios, she said, children who are stunted are likely to have stunted children when they start having one.
“Stunting is often intergenerational: Children who are stunted are also more likely as adults to have stunted children.”
“A stunted child is also more prone to becoming overweight as an adult, posing more health risks.
“Stunting has long- term effects on individuals and societies, including: diminished cognitive and physical development, reduced productive capacity and poor health, and an increased risk of degenerative diseases such as diabetes and other non con communicable diseases”, Asouzu noted.
The dietician stated that stunting is the major form of malnutrition worldwide, most especially among the low income and middle income countries.
Currently, she said Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five.
She pointed out that an estimated two million children in Nigeria suffer from severe acute malnutrition.
Quoting the 2018 Nigeria Demographic and Health Survey, she said, “37 percent of Nigerian children aged between six and 59 months are stunted (short for their age); seven percent are wasted (thin for their height); 22 percent are underweight (thin for their age); and two percent are overweight (heavy for their height).”
Giving insight into stunting and its causes, Asouzu said “Stunting is said to be growth and development impairment which normally occurs in children as a result of poor or inadequate nutrition to meet up with their rapid growing demand.
“What causes stunting in children can be categorised into direct and indirect causative factors.
“The direct factors which are also preventable include inadequate nutrition (not eating enough or eating foods that lack growth-promoting nutrients), recurrent infections or chronic diseases which cause poor nutrient intake, absorption or utilisation.
“This leads to lack of care and stimulation for development because the body is lacking the basic nutrients needed for growth purposes.
“Poor nutrition and a lack of access to diverse and safe foods, poor sanitation and no access to clean drinking water.”
She explained that lack of proper healthcare for children and maternal nutritional and health status before, during and after pregnancy could also result in stunting in children.
“This influences a child’s early growth and development, beginning in the womb.
“For example, intrauterine growth restriction due to maternal under nutrition (estimated by rates of low birth weight) accounts for about 20 percent of childhood stunting.
“If a mother is malnourished, it’s more likely that her baby will be born underweight. This sets off a cycle of stunting”, she affirmed.
On indirect causes of stunting in children, the dietician listed poverty, low status of women, unsanitary health conditions, among others.
The dietician, however, said stunting in children could be prevent, while calling on the government to make it a priority.
Asouzu said focusing on the critical 1,000-day window from a woman’s pregnancy to her child’s second birthday was critical.
“Action can be taken across multiple areas to reduce rates of stunting. First, improving optimal breastfeeding practices is key to ensuring a child’s healthy growth and development.
“Early initiation and exclusive breastfeeding for six months provides protection against gastrointestinal infections, which can lead to severe nutrient depletion and therefore, stunting.
“Second, among the most effective interventions for preventing stunting during the complementary feeding period is improving the quality of children’s diet.
“Evidence suggests that greater dietary diversity and the consumption of foods from animal sources are associated with improved linear growth.
“In order to meet the post-2015 sustainable development goals, policy interventions to reduce stunting in Nigeria should focus on poverty alleviation as well as improving women’s nutrition, child feeding practices and household sanitation”, she recommended.
According to WHO, stunting is a failure of a child to reach one’s linear (height) growth potential.
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