Growth sequences during recovery from infantile malnutrition

Abstract

Permanent growth deficits are assumed to follow malnutrition but little is known about actual growth during recovery from kwashiorkor and severe infantile marasmus. The length, weight, and head circumference of 17 patients with third degree malnutrition (over 40 per cent weight deficit) have been followed. They fall into two groups: Group A with 10 patients 6 to 13 months of age (average 9.2) and Group B with 7 patients 17 to 30 months of age (average 23.6). Group A stayed an average of 6.75 months in the hospital and was followed initially for 7.45 months; Group B, 4.7 and 6.45 months, respectively. In the hospital both made similar gains, most marked in weight (2.5 and 4 times normal for age) and head circumference (2.2 and 4.6 times normal). Gain in length was slightly below normal for age in both. During the first 3 months we noted an early spurt in head growth far in excess of linear growth and bone maturation, possibly the result of early resumption of brain development. During the initial follow-up period Group B made better gains in all measurements but in a further period of 6 months Group A showed an increased rate of gain also. Make-up potential certainly seems to exist but is quite variable. Weight is gained rapidly on a diet adequate in protein and rich in calories. Those with a deficit of 5 per cent or less in body length easily attained normal values, while those with deficits larger than 15 per cent seem to be condemned to permanent stunting despite gains which are close to normal for age. Those with 8 to 15 per cent deficits have shown a continuing tendency to