Stunted growth

Stunted growth, or stunting, describes a condition where a child is significantly shorter than expected for their age due to impaired development. It is most common in the Global South and carries serious long-term effects, including reduced cognitive ability and poorer health in adulthood.

The condition is largely irreversible if it occurs during the critical first 1,000 days from conception to age two. Stunting raises a child's risk of death and typically results in permanent height loss. Affected children often face delayed cognitive development, lower IQ, and poorer school performance. As adults, they are more prone to obesity, diabetes, hypertension, coronary heart disease, metabolic syndrome, and stroke. Women who were stunted as children have a higher risk of childbirth complications due to a smaller pelvis and are more likely to deliver a low-birth-weight baby. Stunting can also pass to the next generation, creating an intergenerational cycle of malnutrition. On a societal level, stunting can reduce economic productivity and limit a country's GDP by up to 3%.

Globally, the prevalence of stunting among children under five fell from 26.3% in 2012 to 22.3% in 2022, and stood at 23.2% in 2024. It is projected to be 19.5% by 2030. Over 85% of stunted children worldwide live in Asia and Africa. The largest regional decline occurred in Asia, dropping from 37.1% in 2000 to 22.3% in 2022. Despite this progress, in 2022, more than 30% of children under five were stunted in 28 countries, most of them in sub-Saharan Africa.

Almost all stunting develops within the 1,000-day window from conception to a child's second birthday. The three main causes in South Asia and most developing countries are poor feeding practices, poor maternal nutrition, and poor sanitation. Leading risk factors include fetal growth restriction (birth weight below the 10th percentile), unimproved sanitation, and diarrhea. Environmental factors account for 22% of stunting cases, while child nutrition accounts for 14%. Women's education, gender equality, and the quantity and quality of available food also play significant roles.

Inadequate complementary feeding and a lack of essential nutrients—beyond just calories—contribute to stunting. Children need diets that meet minimum frequency and diversity requirements. Exclusive breastfeeding is recommended for the first six months, followed by nutritious food alongside breastfeeding from six months to two years. Prolonged exclusive breastfeeding after six months can lead to undernutrition because breast milk alone is insufficient. This is especially common in poor households with uneducated parents, where breastfeeding continues without meeting dietary diversity needs.

Poor maternal nutrition during pregnancy and breastfeeding also causes stunting. Proper prenatal and postnatal nutrition is crucial for healthy birth weight and childhood growth. Low maternal BMI increases the risk of intrauterine growth retardation, which is strongly linked to stunting.