Abstract

BackgroundChronic childhood malnutrition remains common in India. As part of an initiative to improve maternal and child health in urban slums, we collected anthropometric data from a sample of children followed up from birth. We described the proportions of underweight, stunting, and wasting in young children, and examined their relationships with age.MethodsWe used two linked datasets: one based on institutional birth weight records for 17 318 infants, collected prospectively, and one based on follow-up of a subsample of 1941 children under five, collected in early 2010.ResultsMean birth weight was 2736 g (SD 530 g), with a low birth weight (<2500 g) proportion of 22%. 21% of infants had low weight for age standard deviation (z) scores at birth (<−2 SD). At follow-up, 35% of young children had low weight for age, 17% low weight for height, and 47% low height for age. Downward change in weight for age was greater in children who had been born with higher z scores.DiscussionOur data support the idea that much of growth faltering was explained by faltering in height for age, rather than by wasting. Stunting appeared to be established early and the subsequent decline in height for age was limited. Our findings suggest a focus on a younger age-group than the children over the age of three who are prioritized by existing support systems.FundingThe trial during which the birth weight data were collected was funded by the ICICI Foundation for Inclusive Growth (Centre for Child Health and Nutrition), and The Wellcome Trust (081052/Z/06/Z). Subsequent collection, analysis and development of the manuscript was funded by a Wellcome Trust Strategic Award: Population Science of Maternal and Child Survival (085417ma/Z/08/Z). D Osrin is funded by The Wellcome Trust (091561/Z/10/Z).

Highlights

  • Chronic childhood malnutrition remains common in India

  • Birth weight Birth weights were available for 17 318 infants (86% of livebirths): 9173 males and 8145 females

  • Since data were extracted from institutional records, they tended to be unavailable for the 2860 (14%) infants who were born at home

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Summary

Introduction

Chronic childhood malnutrition remains common in India. As part of an initiative to improve maternal and child health in urban slums, we collected anthropometric data from a sample of children followed up from birth. We described the proportions of underweight, stunting, and wasting in young children, and examined their relationships with age. Severe acute malnutrition in childhood has become steadily less common in India [1]. An estimated 52 million children are stunted (height for age standard deviation [z] score < −2) [3]. Urban levels of childhood malnutrition are lower than rural, but the most recent National Family Health Survey (NFHS-3: 2005–6) described stunting in 40%, wasting (weight for height z score < −2 SD) in 17%, and low weight for age (

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