Stunting at birth: An under‐recognized phenomenon with implications for maternal health and nutrition

Background Measurements of length at birth or in the neonatal period are challenging to obtain and often discounted for lack of standardization and validity. Classical “under‐five” stunting rates derive from surveys on children from 6 to 59 mo of age. Objective To assess length‐for‐age (LAZ) within the first 1.5 mo of life among infants from urban (U) and rural (R) sites in the Quetzaltenango Province in the Western Highlands of Guatemala. Methods Supine length was measured to the nearest 0.5 cm by standardized anthropometrics on a SECA 210 infantometer. 104 infants (39% F) were enrolled in 8 rural Mam ‐speaking R villages at 2–46 d of life. 106 infants (50% F) were recruited at an urban U health clinic at 4–33 d of life. Stunting was defined as ≤2 SD of LAZ in relation to the 2006 WHO growth standards. Results In R sites, 100% were indigenous ( Mam ); in the U site, 27% were of indigenous ascent and 73% non‐indigenous. The median R LAZ was −1.55 and prevalence of stunting was 36.5%; the respective U values were −1.41, and 25.5%. The Pearson correlation coefficient of LAZ vs maternal stature for combined U+R was r=0.202 (n=210, p=0.02). Conclusion As linear growth failure in this setting begins in utero, its prevention cannot begin at birth, but must be linked to maternal care strategies during gestation, or even before. Funded by the Nestle Foundation, McGill University, and Graduate Women in Science