What is stunting?

A child is stunted when it is too short for its age. Stunting is the result of undernutrition over a longer period, often combined with repeated infections. In 2024, 150.2 million children under five were stunted worldwide: almost one in four. Most of them live in Asia and Africa.

How is stunting measured?

A child is stunted when its height for age is more than two standard deviations below the median of the WHO Child Growth Standards. Health workers measure the length or height of the child and compare it with the WHO growth curves. Below three standard deviations is called severe stunting.

The cycle of stunting: malnourished mother, underweight baby, stunted child, malnourished young girl

Causes of stunting

Stunting develops slowly, mostly during the first 1,000 days: from conception to a child’s second birthday. The main causes are:

Poor nutrition of the mother before and during pregnancy, which leads to a low birth weight.
Too little breastfeeding in the first six months.
Complementary food from six months onwards that contains too little energy, protein, iron, zinc and vitamin A, or that lacks variety.
Repeated diarrhoea and infections, often caused by unsafe drinking water and poor sanitation.
Poverty and limited knowledge of what a young child needs.

Effects of stunting

Stunting is more than being short. It affects a child for life.

Brain development: stunted children learn less easily and perform worse at school.
Income: children who do not reach their developmental potential earn an estimated 20 percent less as adults.
Health: stunted children are more vulnerable to infections. Later in life, when diets change, they run a higher risk of overweight, diabetes and high blood pressure.
The next generation: stunted girls more often give birth to small babies, so the cycle continues.

Growth lost after the age of two is hard to recover. That is why early prevention matters most.

stunting Many children in developing countries are exposed to multiple risks for poor development including poverty and poor health and nutrition.

There are few national data for children’s development but our conservative estimate is that more than 200 million children under 5 years of age in developing countries are not developing to their full potential. Sub-Saharan African countries have the highest percentage of disadvantaged children but the largest number live in south Asia. The children will subsequently do poorly in school and are likely to transfer poverty to the next generation.

We estimate that this loss of human potential is associated with more than a 20% deficit in adult income and will have implications for national development. The proximal causes of poor child development are analysed in the second paper in this series.

The problem of poor child development will remain unless a substantial effort is made to mount appropriate integrated programmes. There is increasing evidence that early interventions can help prevent the loss of potential in affected children and improvements can happen rapidly (see third paper in this series). In view of the high cost of poor child development, both economically and in terms of equity and individual well-being, and the availability of effective interventions, we can no longer justify inactivity.

Grantham-McGregor S, et al.

The Lancet, 2007

How to prevent stunting

Prevention works best in the first 1,000 days and combines nutrition, health and hygiene:

Good nutrition for girls and pregnant women, with enough energy, protein, iron and folic acid.
Exclusive breastfeeding for the first six months, and continued breastfeeding up to two years or longer.
From six months: varied and energy dense complementary food, several times a day.
Clean drinking water, handwashing and toilets to prevent diarrhoea.
Regular growth monitoring, so problems are spotted early.

The role of local, plant-based food

Many families can improve their diet with what grows nearby. Beans, lentils, chickpeas, groundnuts and sesame provide protein and zinc. Dark green leafy vegetables such as amaranth and moringa provide iron, folate and vitamin A. Orange sweet potato and pumpkin add vitamin A. Fruit rich in vitamin C, eaten with the meal, helps the body absorb iron. Soaking, sprouting and fermenting grains and legumes also improves the absorption of iron and zinc. For young children on a mostly plant-based diet, energy density, iron, zinc and vitamin B12 need extra attention.

What Green Food Foundation does

We work with local NGOs in Nepal, Uganda, Kenya, India and Tanzania. Through train the trainer programmes we teach health workers and mother groups how to prepare nutritious meals with local products, and we help set up vegetable gardens. Read more about how we work or support our work against stunting.

Sources

UNICEF, WHO, World Bank Group. Joint Child Malnutrition Estimates, 2025 edition.
WHO. WHO Child Growth Standards. Geneva, 2006.
Grantham-McGregor S, et al. Developmental potential in the first 5 years for children in developing countries. The Lancet, 2007.
Lu C, Black MM, Richter LM. Risk of poor development in young children in low-income and middle-income countries. The Lancet Global Health, 2016.
Black MM, et al. Early childhood development coming of age: science through the life course. The Lancet, 2017.