Seasonal growth patterns in rural Nepali children

Abstract

This paper reports on the prevalence of growth retardation, the impact of seasonality on height and weight gains, and significant relationships between growth velocity, nutritional status and morbidity, for a population living at subsistence level in rural Nepal. Monthly variation in growth pattern was examined for 71 boys and girls 0-49 months of age. At the height of the monsoon season, 71% of children were moderately stunted, but none was wasted (mean -2.61 SD height-for-age and -0.91 SD weight-for-height by reference to NCHS z-score values). Measures of stunting deteriorated from moderate to severe after 1 year of age. No differences by sex or ethnicity were detected. Environmental changes from the winter to the monsoon seasons were reflected in significant losses of weight and lower weight-for-height z-scores, especially for 0-35 month-olds, although height for 12-35-month-olds continued to be gained over this period. Growth velocity was significantly related to previous growth status (thinner and shorter children did not show catch-up in height or weight) and to morbidity reported over the period of observation. The prevalence of illnesses rose six-fold from the winter to the monsoon, and children with a high frequency of illnesses experienced a significant shortfall in weight and height increments. A poor diet and recurrent illnesses explain the slow and uneven growth of these children. Despite an increase in women's agricultural workloads in the monsoon season, childcare patterns per se do not seem to adversely affect small children. Small stature through later childhood and in adults is one consequence of the growth pattern seen at these young ages.

PIP: The monthly variation in growth pattern was examined for 71 boys and girls aged 0-49 months of age in rural Nepal. At the height of the monsoon season, 71% of children were moderately stunted, but none was wasted. Stunting worsened from moderate to severe after 1 year of age with no differences observed by sex or ethnicity. Overall measures of wasting significantly worsen over the winter to monsoon period, while measures of stunting improve. In particular, there was significant wasting especially among 0-35 month olds, while height for 12-35 month olds continued to be gained over the period. Growth velocity was significantly related to previous growth status and to morbidity reported over the period of observation. The prevalence of illnesses increased six-fold from the winter to monsoon season and children with a high incidence of illness experienced a significant shortfall in weight and height increments. Poor diet and recurrent illness explain the slow and uneven growth of these children. Increased women's workload during the monsoon season does not appear to adversely affect small children through poor child care.