Children living in unsanitary conditions in an urban slum in India, at risk of diarrhea and<unk>  Child next to open sewer in slum in Kampala, Uganda, at risk of diarrhea and<unk>  The causes for stunting are principally very similar if not the same as the causes for malnutrition in children. Most stunting happens during the 1,000-day period that spans from conception to a child's second birthday. The three main causes of stunting in South Asia, and probably in most developing countries, are poor feeding practices, poor maternal nutrition, and poor sanitation. Feeding practices Inadequate complementary child feeding and a general lack of vital nutrients beside pure caloric intake is one cause for<unk> . Children need to be fed diets which meet the minimum requirements in terms of frequency and diversity in order to prevent undernutrition. Exclusive breastfeeding is recommended for the first six months of life and complementary feeding of nutritious food alongside breastfeeding for children aged six months to 2-years-old. Prolonged exclusive breastfeeding is associated with undernutrition because breast milk alone is nutritionally insufficient for children over six months old. Breastfeeding in long time with inadequate complementary feeding leads to<unk>  failure due to insufficient nutrients which are essential for childhood development. The relationship between undernutrition and prolonged duration of breastfeeding is mostly observed among children from poor households and whose parents are uneducated as they are more likely to continue breast-feeding without meeting minimum dietary diversity requirement. Maternal nutrition Poor maternal nutrition during pregnancy and breastfeeding can lead to<unk>  of their children. Proper nutrition for mothers during the prenatal and postnatal period is important for ensuring healthy birth weight and for healthy childhood<unk> . Prenatal causes of child stunting are associated with maternal undernutrition. Low maternal BMI predisposes the fetus to poor<unk>  leading to intrauterine<unk>  retardation, which is strongly associated with low birth weight and size. Women who are underweight or anemic during pregnancy, are more likely to have<unk>  children which perpetuates the inter-generational transmission of stunting. Children born with low birthweight are more at risk of stunting. However, the effect of prenatal undernutrition can be addressed during the postnatal period through proper child feeding practices. Sanitation There is most likely a link between children's linear<unk>  and household sanitation practices. The ingestion of high quantities of fecal bacteria by young children through putting soiled fingers or household items in the mouth leads to intestinal infections. This affect children's nutritional status by diminishing appetite, reducing nutrient absorption, and increasing nutrient losses. The diseases recurrent diarrhea and intestinal worm infections (helminthiasis) which are both linked to poor sanitation have been shown to contribute to child stunting. The evidence that a condition called environmental enteropathy also stunts children is not conclusively available yet, although the link is plausible and several studies are underway on this topic. Environmental enteropathy is a syndrome causing changes in the small intestine of persons and can be brought on due to lacking basic sanitary facilities and being exposed to faecal contamination on a long-term basis. Research on a global level has found that the proportion of stunting that could be attributed to five or more episodes of diarrhoea before two years of age was 25%. Since diarrhoea is closely linked with water, sanitation and hygiene (WASH), this is a good indicator for the connection between WASH and<unk> . To what extent improvements in drinking water safety, toilet use and good handwashing practices contribute to reduce stunting depends on the how bad these practices were prior to interventions.
Stunted growth
Growth attenuation
Hypergraphia
Failure to thrive
Hyperdontia
Psychosocial short stature
Dwarfism
Constitutional growth delay