Growth Disorders

Child growth is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Growth is influenced by many factors such as heredity, genetic or congenital, illness and medications, nutrition, hormones, and psychosocial environment. Measurements of growth—height and weight—are a very inexpensive service that should be offered by all health-care providers rendering care to children.

The internationally recommended way to assess malnutrition at population level is to take body or anthropometric measurements (e.g., weight and height). Based on combinations of these body measurements, anthropometric indices are constructed. These indices are essential for the interpretation of body measurements as, for example, weight alone has no meaning unless it is related to an individual's age or height. In children, the three most commonly used anthropometric indices are weight for height, height forage, and weight for age. These indices can be expressed in terms of z-scores, percentiles, or percentage of median, which enable comparison of a child or a group of children with a reference population.

A normal growth pattern does not guarantee overall health; however, children with abnormal growth patterns frequently have nutritional complications of specific clinical disorders (e.g., cystic fibrosis, inflammatory bowel disease) or poor socioeconomic conditions. A child who is two standard deviations (SDs) or more below the mean height for children of that sex and chronologic age (and ideally of the same racial ethnic group) is said to have short stature. A single measurement of height is much less important in assessing growth than is the pattern of growth over a period of time; the key finding is slowed growth that progressively deviates from a previously defined growth channel (or percentile).

Children who suffer from growth retardation as a result of poor diets and/or recurrent infections tend to have more frequent episodes of severe diarrhea and are more susceptible to several infectious diseases, such as malaria, meningitis, and pneumonia. In addition, there is strong evidence that impaired growth is associated with delayed mental development, poor school performance, and reduced intellectual capacity.