Stunting in children: know the causes, characteristics, and how to deal with it

The growth of a child is not only seen from body weight, but also in height. This is because the child's height is one of the factors that mark stunting and a marker of whether the child's nutrition is fulfilled or not. Then, what is stunting and what causes it? The following is a complete explanation of these health conditions.

What is stunting?

Quoting from the Stunting Bulletin issued by the Indonesian Ministry of Health, stunting is a condition characterized when the length or height of a child is less than its age.

Simply put, stunting is a condition in which children experience growth problems, causing their body to be shorter than their peers.

Many do not know that short children are a sign of chronic nutritional problems in the growing body of your little one.

Moreover, if this condition is experienced by a child who is under the age of 2 years and must be treated promptly and appropriately.

Children are classified as stunting when their length or height is below -2 standard deviation (SD).

Assessment of nutritional status on this one usually uses a child growth chart (GPA) from WHO.

Short stature in children who are below normal standards is the result of a long-term malnutrition.

This then hampers the child's height growth, resulting in him being classified as stunting.

So in short, a child with a short stature may not necessarily be stunted.

This condition only occurs when the child's daily nutritional intake is lacking, which affects the development of their height.

What causes stunting in children?

This health problem is the result or result of various factors that occurred in the past.

These factors include poor nutrition, repeated infections, premature babies, and low birth weight (LBW).

This condition of insufficient nutritional intake usually occurs not only after birth.

But it can be started when he is still in the womb. Here are some things that cause stunting in children.

Lack of nutritional intake during pregnancy

WHO, as the World Health Organization, states that about 20 percent of stunting has occurred while the baby is still in the womb.

This is because the mother's intake during pregnancy is less nutritious and of good quality, so that the nutrition received by the fetus tends to be low.

Eventually, the growth in the womb begins to slow down and continues after birth.

Therefore, it is important to meet various important nutrients during pregnancy.

Inadequate children's nutritional needs

In addition, this condition can also occur due to insufficient food for toddlers when they are under 2 years of age.

Either the breastfeeding position is not right, the exclusive breastfeeding is not given, or the complementary foods (complementary foods) that are given do not contain quality nutrients.

There are many theories that state that lack of food intake can also be one of the main factors causing stunting.

Especially the intake of foods containing zinc, iron, and protein when the child is still a toddler.

Launching from the book Nutrition for Children and Adolescents, this incident generally begins to develop when a child is 3 months old.

This development process begins to slow down gradually when the child is 3 years old.

After that, the height assessment graph based on age (height / age), continues to move along the standard curve but at the bottom.

There is a slight difference in the stunting conditions experienced by the 2-3 year age group and children over 3 years of age.

In children under 2-3 years of age, a low height graph measurement for age (height / age) can illustrate the ongoing stunting process.

Meanwhile, in children who are older than that, this condition indicates that the failure of the child's growth has indeed occurred (stunted).

Apart from those mentioned above, there are several other factors that cause stunting in children, namely:

• Lack of knowledge of mothers about nutrition before pregnancy, during pregnancy, and after childbirth.
• Limited access to health services, including pregnancy services and postnatal (after giving birth).
• Lack of access to clean water and sanitation.
• There is still a lack of access to nutritious food because it is relatively expensive.

To prevent this, pregnant women need to avoid the above factors.

The characteristics of stunting in children

It should be understood that not all children under five who are short are stunted.

This health problem is a very short body condition seen from the standard measurement of height according to age based on WHO standards.

According to the Indonesian Ministry of Health, it can be seen that toddlers are stunted if their length or height has been measured, then compared with the standard, and the results of this measurement are in the range below normal.

A child is included in stunting or not, depending on the results of these measurements. So it can't just be guessed or guessed without measurement.

In addition to the short stature of children his age, there are also other characteristics, namely:

• Growth slows down
• The face looks younger than children his age
• Late teething
• Poor performance on ability to focus and learning memory
• 8-10 years old children become more quiet, not making much eye contact with those around them
• Toddler weight does not increase and even tends to decrease.
• Stunted development of the child's body, such as late menarche (girl's first menstruation).
• Children are susceptible to various infectious diseases.

Meanwhile, to find out whether the child's height is normal or not, you must routinely have it checked by the nearest health service.

You can take your little one to the doctor, midwife, posyandu, or health center every month.

What impact do these health problems have on children?

Stunting is failure to thrive due to the accumulation of insufficient nutrients that last a long time from pregnancy to 24 months of age.

Therefore, this condition can affect the growth and development of the child as a whole.

The short-term impact of stunting is disruption in brain development, intelligence, disruption in physical growth, and metabolic disorders.

The long-term impact, stunting that is not handled properly as early as possible impacts:

• Reducing the cognitive development abilities of the child's brain
• Weak immunity so it is easy to get sick
• High risk of developing metabolic diseases such as obesity
• Heart disease
• Blood vessel disease.
• Difficulty learning

In fact, when they are adults, children with short stature will have a low level of productivity and find it difficult to compete in the world of work.

For girls who are stunted, they are at risk for developing health and development problems in their offspring as adults.

This usually occurs in adult women with a height less than 145 cm due to stunting since childhood.

The reason is, pregnant women who are short are below average (maternal stunting) will experience slowed blood flow to the fetus as well as the growth of the uterus and placenta.

It is not impossible, this condition will have a negative impact on the condition of the baby who is born.

Babies born to mothers with below average height are at risk of serious medical complications, even stunted growth.

The development of the nerves and intellectual abilities of these babies can be hampered along with the child's height not according to age.

Like stunting since childhood, babies with this condition will continue to experience the same thing until they reach adulthood.

How is stunting treated in infants?

Even though stunting has an impact until adulthood, this condition can be treated in a good way.

Launching from the Stunting Bulletin according to the Indonesian Ministry of Health, stunting is influenced by parenting styles, coverage and quality of health services, the environment, and food security.

One of the first treatments that can be done for children with below normal height who are diagnosed with stunting, is to provide them with proper parenting.

This includes early initiation of breastfeeding (IMD), exclusive breastfeeding until the age of 6 months, and breastfeeding together with complementary breastfeeding until the child is 2 years old.

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend that babies aged 6-23 months get optimal complementary foods (complementary foods).

These feeding provisions should contain a minimum of 4 or more than 7 types of food.

These types of food include cereals or tubers, nuts, dairy products, eggs or other protein sources, vegetables and fruits rich in vitamin A or others.

On the other hand, also pay attention to the limits of the provisions minimum meal frequency (MMF), for infants aged 6-23 months who are given and not given ASI, and have received complementary foods.

For breastfed babies

• Age 6-8 months: 2 times per day or more
• 9-23 months: 3 times per day or more

Meanwhile, babies who are not breastfed, aged 6-23 months, are 4 times per day or more.

Not only that, the availability of food in each family also plays a role in overcoming stunting.

This can be done, for example, by increasing the quality of the daily food consumed.

How can you prevent stunting?

The incidence of children with short stature is not a new problem in the world of world health.

In Indonesia itself, stunting is a nutritional problem in children which is still a homework that must be done properly.

It is proven that according to Nutritional Status Monitoring (PSG) data from the Indonesian Ministry of Health, the number of stunted children is quite high.

The number of cases of children with this condition had the highest number when compared to other nutritional problems, such as malnourished, underweight, and obese children.

The next question is, can stunting in children be prevented from an early age?

The answer, yes. Stunting in children is one of several priority programs launched by the government so that the number of cases is reduced every year.

There are various efforts that can be made to prevent stunting according to the Minister of Health Regulation Number 39 of 2016.

How to prevent stunting according to the Guidelines for Implementing a Healthy Indonesia Program with a Family Approach, namely:

How to prevent stunting for pregnant women and childbirth

Several ways to prevent stunting for pregnant and childbirth women, namely:

• Optimal health monitoring and treatment, in the first 1,000 days of a baby's life.
• Pregnancy examination or ante natal care (ANC) regularly and periodically.
• Carry out the delivery process at the nearest health facility, such as a doctor, midwife, and health center.
• Provide foods high in calories, protein, and micronutrients for babies (TKPM).
• Detecting infectious and non-communicable diseases early on.
• Eradicating the possibility of children getting worms.
• Perform exclusive breastfeeding for 6 months.

You can discuss with your obstetrician about how to prevent stunting that has been suggested above.

How to prevent stunting for children under five

Meanwhile, how to prevent stunting in toddlers, namely:

• Routinely monitor the development of toddlers.
• Provide additional food (PMT) for toddlers.
• Perform early stimulation of child development.
• Providing optimal health care and services for children.

You can discuss with your pediatrician to adjust to your little one's habits, so that stunting prevention can be done.

How to prevent stunting for school-age children

School children also need to be provided with supplies as an effort to prevent stunting, such as:

• Provide nutritional intake according to the daily needs of children.
• Teach children knowledge related to nutrition and health.

Do it slowly in language that is easy for children to understand.

For teenagers

Although stunting in adolescents cannot be treated, treatment can still be done, including:

• Familiarize children with clean and healthy living habits (PHBS), a balanced nutritional pattern, not smoking, and not using drugs
• Teach children about reproductive health

You can do this for children who have entered their teens, namely 14-17 years.

For young adults

Here's how to prevent stunting in young adults:

• Understanding about family planning (KB)
• Conduct early detection of infectious and non-communicable diseases
• Always apply a clean and healthy lifestyle (PHBS), a balanced nutrition pattern, do not smoke, and do not use drugs.

In essence, if you want to prevent stunting, the intake and nutritional status of a prospective mother must be good.

This is then accompanied by providing quality food intake when the child is born.

Can a stunted child grow back to normal?

Unfortunately, stunting is a condition that cannot be reversed.

This means that when a child is stunted since he was a toddler, his growth will continue to slow down until he is an adult.

At puberty, he cannot achieve maximum growth due to being stunted as a child.

Even though you have given him food that is rich in nutrients, his growth still cannot be maximized like other normal children.

However, it is still important for you to provide a variety of highly nutritious foods to prevent your little one's condition from getting worse and the growth problems he is experiencing getting worse.

Therefore, this can actually be prevented by providing maximum nutrition in the early days of life. To be precise during the first 1,000 days of a child's life.

If you know that your little one is stunted, you should immediately consult your pediatrician so that it can be resolved quickly.

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