Play Live Radio
Next Up:
0:00 0:00
Available On Air Stations

Stunting From Malnutrition Affects 1 In 4 Kids Worldwide

Renande Raphael, aged 16 months, is measured to check whether she is growing normally. She's part of a trial in Haiti to see if an extra daily snack of enriched peanut butter prevents stunting and malnutrition.
Alex E. Proimos
via flickr
Renande Raphael, aged 16 months, is measured to check whether she is growing normally. She's part of a trial in Haiti to see if an extra daily snack of enriched peanut butter prevents stunting and malnutrition.

Babies and toddlers in the poorest parts of the world are getting better fed.

What's the proof? Stunting in kids – a sign of poor nutrition early in life — has dropped by a third in the past two decades, UNICEF reported Monday. But there's a long way to go. Globally, a quarter of kids under the age of 5 were stunted in 2011. That's roughly 165 million children worldwide, with nearly 75 percent of them living in sub-Saharan Africa and South Asia, the report says.

The progress has been most dramatic in East Asia and Latin America, where stunting has decreased by a whopping 70 and 50 percent, respectively. Even very poor countries, like Ethiopia and Nepal, have quickly made progress against malnutrition and stunting.

"People were always skeptical that you could reduce the number of malnourished children quickly without greatly improving a country's economy," Werner Schultink, who leads the nutrition division for UNICEF, tells The Salt. "It's very doable, and it doesn't cost $100 per child. It's relatively cheap."

Kids are considered "stunted" when their heights fall below the fifth percentile for their age. But stunting goes beyond inches and growth charts.

Stunted kids are more likely to get sick, and they tend to have a harder time in school, Schultink says. Such setbacks can translate to lower paying jobs later in life.

Recent studies have found that proper nutrition is most critical early in life. If babies don't get enough calories and Vitamin A, iron and folic acid in the womb, and during the first two years, their bodies and brains don't develop properly. And the damage can be irreversible.

So UNICEF has shifted its nutritional programs to focus on pregnant women and kids under age 2. Its new report describes some of the strategies that have worked the best.

First and foremost, Schultink says, "you've got to get mothers breast-feeding as soon as possible."

Here in the U.S., new mothers have an array of options when it comes to feeding their infants. But in the places where food is limited, breast-feeding is the safest option — especially during the first six months — because even malnourished moms have pretty nutritious breast milk.

In these places, breast-feeding improves brain development, kick-starts a baby's immune system and reduces the overall risk of dying early in life, the report says. So many countries, like India, Ethiopia and Nepal, have focused on teaching health workers the importance of breast-feeding and then having them spread the word throughout their communities.

Vietnam recently banned advertising on baby formula and extended its paid maternity leave, with the hopes of promoting breast-feeding.

Other countries, like Peru, Ecuador and South Africa have been trying out cash transfer programs, in which the government gives families a lump sum of money to buy food for their babies and toddlers.

It's still up for debate whether these programs work. A recent study by the World Bank found mixed results in Mexico and Brazil. Some programs were linked to higher kids' heights, but others had no impact.

"In principle, cash transfer programs should be an enormous help," Schultink says. "But you need make sure it doesn't just stop with the cash. Families still need access to health care services and healthy foods."

For countries where vitamins and minerals are tough to come by, large nationwide campaigns that hand out capsules and powdered supplements have been effective, the report finds.

And for extreme cases of malnourishment, peanut butter-based supplements, such as Plumpy'Nut, have been a game-changer, Schultink says. "Five to 10 years ago, these kids would need to be treated in a hospital setting," he says. "But with this new product, it allows us to treat them in their homes, and the kids recuperate completely. So instead of treating thousands of kids, we can treat them by the millions."

Copyright 2020 NPR. To see more, visit

Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.
KUER is listener-supported public radio. Support this work by making a donation today.