The State of the World’s Children published by UNICEF provides current information on the health and growth of children for every country, region, and for the world.[10]UNICEF. The state of the world's children 2021: on my mind: promoting, protecting and caring for children’s mental health. 2021 [internet publication].
https://www.unicef.org/reports/state-worlds-children-2021
Based on the data reported in 2021, among children 0-59 months:
Stunting, defined as the percentage of children <-2 SD from the median height-for-age of the WHO Child Growth Standards, is 22% globally, 3% for Western Europe, 3% for North America, 32% for sub-Saharan Africa, and 32% for South Asia.
Wasting, defined as the percentage of children <-2 SD from the median weight-for height of the WHO Child Growth Standards, is 7% globally, 0% for Western Europe, <1% for North America, 5% for sub-Saharan Africa, and 15% for South Asia.
Among school-age children (ages 5-19 years):
Thinness, defined as the percentage of children with BMI <-2 SD of the median according to WHO growth references, is 11% globally, 1% for Western Europe, 1% for North America, 7% for sub-Saharan Africa, and 25% for South Asia.
Although the Multi-country Growth Reference Study illustrates that under optimal conditions, children’s early growth does not differ across regions, these data reveal differing growth patterns across regions, likely associated with differing conditions, including dietary patterns.[11]UNICEF: Recommendations for data collection, analysis and reporting on anthropometric indicators in children under 5 years of age. May 2019 [internet publication].
https://data.unicef.org/resources/data-collection-analysis-reporting-on-anthropometric-indicators-in-children-under-5
[12]World Health Organization. Levels and trends in child malnutrition: UNICEF/WHO/The World Bank Group joint child malnutrition estimates: key findings of the 2021 edition. May 2021 [internet publication].
https://www.who.int/publications/i/item/9789240025257
[13]Akombi BJ, Chitekwe S, Sahle BW, et al. Estimating the double burden of malnutrition among 595,975 children in 65 low- and middle-income countries: a meta-analysis of demographic and health surveys. Int J Environ Res Public Health. 2019 Aug;16(16):2886.
https://www.mdpi.com/1660-4601/16/16/2886
http://www.ncbi.nlm.nih.gov/pubmed/31412530?tool=bestpractice.com
[14]Borland E, Dalenius K, Grummer-Strawn L, et al. Pediatric nutrition surveillance 2010 report. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2012.
https://stacks.cdc.gov/view/cdc/11951
Population-based surveys have found that up to 50% of children with faltering growth are not identified by healthcare providers.[15]Wright CM. Identification and management of failure to thrive: a community perspective. Arch Dis Child. 2000 Jan;82(1):5-9.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1718189/pdf/v082p00005.pdf
http://www.ncbi.nlm.nih.gov/pubmed/10630901?tool=bestpractice.com
Although faltering growth is more common among children from low-income families than from middle-income families, it occurs in all segments of the population.[16]Wright CM, Parkinson KN, Drewett RF. The influence of maternal socioeconomic and emotional factors on infant weight gain and weight faltering (failure to thrive): data from a prospective birth cohort. Arch Dis Child. 2006 Apr;91(4):312-7.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2065961
http://www.ncbi.nlm.nih.gov/pubmed/16397011?tool=bestpractice.com
Poverty can affect children directly through lack of food, health care, and education, and indirectly through increased family stress, which may interfere with parents' ability to regularly provide nutritious meals and in a nurturing manner.[8]Frank DA, Blenner S, Wilbur MD, et al. Failure to thrive. In: Reece RM, Christian C, eds. Child abuse: medical diagnosis and management, 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008. Food insecurity has been associated with hospitalisations, poor health, and developmental risk among infants, and with developmental, academic, and learning problems among school-age children.[17]Cook JT, Frank DA, Levenson SM, et al. Child food insecurity increases risks posed by household food insecurity to young children's health. J Nutr. 2006 Apr;136(4):1073-6.
https://www.sciencedirect.com/science/article/pii/S0022316622082037?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/16549481?tool=bestpractice.com
[18]Rose-Jacobs R, Black MM, Casey PH, et al. Household food insecurity: associations with at-risk infant and toddler development. Pediatrics. 2008 Jan;121(1):65-72.
http://www.ncbi.nlm.nih.gov/pubmed/18166558?tool=bestpractice.com
[19]Alaimo K, Olson C, Frongillo EA Jr. Food insufficiency and American school-aged children's cognitive, academic, and psychosocial development. Pediatrics. 2001 Jul;108(1):44-53.
http://www.ncbi.nlm.nih.gov/pubmed/11433053?tool=bestpractice.com
Children can experience poor growth in homes of any social class in cases of problematic parent-child relationships, parental psychopathology, family dysfunction, or organic pathology. The impact of such problems increases in the context of poverty.