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Stunting: An over-diagnosed condition?
Stunting has become one of the most popular medical issues to date. The frequently asked questions from parents at pediatric clinics nowadays include, “Does my child suffer from stunting?” As stunting has devastating effects on child development and growth, it is understandable that parents keenly ask such questions.
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Children are encouraged to play together at Aerokids Play School in Sunter, North Jakarta. (-/Aruna Harjani)
T
he new president and vice president will take up office upon their inauguration this October. It is a relief that both presidential candidates have demonstrated attention to the nutritional status of Indonesian children, one focusing on reducing the prevalence of stunting starting before conception, and the other focusing on dietary intervention.
Stunting has become one of the most popular medical issues to date. The frequently asked questions from parents at pediatric clinics nowadays include, “Does my child suffer from stunting?” As stunting has devastating effects on child development and growth, it is understandable that parents keenly ask such questions.
But first we need to understand that stunting is only one of several forms of malnutrition. First, there is underweight that literally means having too low a bodyweight for one’s age, defined by the World Health Organization (WHO) as a bodyweight “more than 2 standard deviations below the median of a standard population”. Second, there is wasting, or being thin for one’s height, defined by the WHO as having a weight for height below -2 SD.
Third, overweight, defined as weight for height above +2 SD. You may be underweight according to your age, but you can be normal or even overweight according to your height. Last but not least is stunting. By this standard, stunting is having height for age below -2 SD or simply being too short for one’s age.
Stunted linear growth, especially in children below 2 years of age (the first 1,000 days) affects brain growth, as the development of neuron cells is at its peak during the first two years. Children who are stunted in early life also bear an increased risk of developing obesity, diabetes, cancer or cardiovascular disease in later phases of childhood or in adulthood.
According to the WHO, stunting is impaired growth and development children experience because of poor nutrition, repeated infections or inadequate opportunities to play and learn. The WHO has developed a normal standard growth chart it claims is applicable to any child, regardless of ethnicity, socio-economic status or type of feeding.
The WHO standard growth chart was developed after the completion of the WHO Multicenter Growth Reference Study (MGRS), which was implemented between 1997 and 2013, to develop a new growth chart that would show how children should grow in all countries, rather than merely describing how they grew at a particular time and place.
