Stunting is a condition when a child's height is shorter than the standard for his age due to long-term malnutrition. This condition can be caused by malnutrition experienced by the mother during pregnancy or the child during growth.
Based on WHO data, a country is said to have a stunting problem when the number of cases is above 20%. Meanwhile, based on 2018 data, the number of stunting cases in Indonesia is 30.8%, or three out of ten Indonesian children. Therefore, stunting is still a problem that must be addressed immediately.
A child's body posture is influenced by various factors, such as genetics, hormones, and nutritional intake. Therefore, there are children who are short because their parents are also short.
However, stunting is different from short stature. A child with stunting must have a short body, but a child with a short stature does not necessarily suffer from stunting.
Causes of Stunting
The main cause of stunting is malnutrition in the long term (chronic). This lack of nutritional intake can occur since the baby is still in the womb because the mother does not have enough nutritional needs during pregnancy.
In addition, children whose nutritional needs are not met during their growth can also experience stunting.
Risk factors for stunting
The risk of stunting in children can increase if the pregnant mother has some of the following conditions or factors:
- Intrauterine growth restriction (IUGR)
- Short stature
- The mother's weight does not increase during pregnancy
- Low level of education
- Poverty
- Live in an environment with poor sanitation and do not get access to clean water
While in children, some conditions that increase the risk of stunting are:
- Experiencing abandonment
- Not getting exclusive breast milk
- Getting poor quality MPASI nutrition
- Suffering from diseases that prevent the absorption of nutrients, such as tuberculosis , anemia, congenital heart disease , chronic infections, and malabsorption syndrome
Symptoms of Stunting
Symptoms of stunting are often not noticed, because the child is only suspected of having a short body. However, symptoms of stunting can generally be seen when a child is 2 years old.
The symptoms that show a child is stunted are:
- The child's body is shorter compared to the standard height of children his age
- The child's weight can be lower for a child of his age
- Bone growth is inhibited
- Easy to get sick
- Learning disorders
- Developmental disorders
When suffering from a chronic disease, children with stunting can experience a number of the following symptoms:
- Not actively playing
- Chronic cough, fever , and sweating at night
- The child's body turns blue when crying ( cyanosis )
- Drowning often
- Shortness of breath
- The tip of the finger is shaped like a clubbing finger .
- The baby cannot breastfeed well
When should you go to the doctor?
Immediately see a doctor if your child's height seems shorter than a child his age, especially if the child experiences the symptoms mentioned above.
In addition, the child's height, weight, and growth should be routinely checked by a doctor or checked at a posyandu.
For children under 2 years of age, the examination should be done every 1-2 months. Meanwhile, examinations for children over 2 years of age are done once every 1 year.
Diagnosis of Stunting
First of all, the doctor will ask questions about the child's food intake, breastfeeding history, history of pregnancy and delivery, and the child's living environment. After that, the doctor will perform a complete physical examination to see the signs of stunting in the child.
The doctor will also measure the child's length or height, body weight, head circumference and arm circumference. A child can be suspected of suffering from stunting if his height is below the red line (-2 SD) based on the WHO growth curve.
However, the examination needs to be done several times to ensure if the child is stunted.
To confirm the diagnosis, the doctor will also perform supporting examinations including:
- Blood tests , to detect health disorders, such as tuberculosis, chronic infections, or anemia
- Urine test , to detect white blood cells in the urine which can be a sign of infection
- Examination of feces , to check for parasitic infections or lactose intolerance in babies or children
- Echocardiography or USG of the heart, to detect congenital heart disease
- Chest X-ray, to see the condition of the heart and lungs
- Mantoux test , to diagnose TB disease
Treatment of Stunting
Treatment of stunting can include treating the underlying disease, improving nutrition, giving supplements, and adopting a clean and healthy lifestyle. Here are the actions that the doctor can take:
- Treating the underlying disease, for example giving antituberculosis drugs when a child suffers from TB
- Provides additional nutrition, in the form of foods rich in animal protein, fat, and calories
- Provide supplements, in the form of vitamin A, zinc , iron , calcium, and iodine
- Advising families to improve sanitation and apply clean and healthy living behavior ( PHBS ), in order to achieve a healthy family
Complications of Stunting
Stunting that is not treated immediately can cause complications in the form of:
- Disturbances in the development of the child's brain so that it interferes with the learning process and lowers his performance
- Metabolic diseases in adulthood, such as obesity and diabetes
- Children often get sick and get infections
Prevention of Stunting
Stunting can be prevented by avoiding factors that can increase the risk. Efforts that can be made include:
- Adequate nutritional intake before planning pregnancy and during pregnancy
- Adequate nutritional intake, especially during the first 1,000 days of life, from the time the egg is fertilized until the child is 2 years old
- Give exclusive breast milk until the baby is 6 months old
- Ensure children get complete immunization