title: Successive 1-Month Weight Increments in Infancy Can Be Used to Screen for Faltering Linear Growth.
abstract: BACKGROUND
  Linear growth faltering in the first 2 y contributes greatly to a high stunting burden, and prevention is hampered by the limited capacity in primary health care for timely screening and intervention.
  
  
  OBJECTIVE
  This study aimed to determine an approach to predicting long-term stunting from consecutive 1-mo weight increments in the first year of life.
  
  
  METHODS
  By using the reference sample of the WHO velocity standards, the analysis explored patterns of consecutive monthly weight increments among healthy infants. Four candidate screening thresholds of successive increments that could predict stunting were considered, and one was selected for further testing. The selected threshold was applied in a cohort of Bangladeshi infants to assess its predictive value for stunting at ages 12 and 24 mo.
  
  
  RESULTS
  Between birth and age 12 mo, 72.6% of infants in the WHO sample tracked within 1 SD of their weight and length. The selected screening criterion ("event") was 2 consecutive monthly increments below the 15th percentile. Bangladeshi infants were born relatively small and, on average, tracked downward from approximately age 6 to <24 mo (51% stunted). The population-attributable risk of stunting associated with the event was 14% at 12 mo and 9% at 24 mo. Assuming the screening strategy is effective, the estimated preventable proportion in the group who experienced the event would be 34% at 12 mo and 24% at 24 mo.
  
  
  CONCLUSIONS
  This analysis offers an approach for frontline workers to identify children at risk of stunting, allowing for timely initiation of preventive measures. It opens avenues for further investigation into evidence-informed application of the WHO growth velocity standards.
authors.affiliation: Family and Reproductive Health Cluster, WHO Regional Office for Africa, Brazzaville, Republic of Congo; onyangoa@who.int.
authors.forename: Adelheid W
authors.initials: AW
authors.lastname: Onyango
authors.affiliation: Department of Nutrition, WHO, Geneva, Switzerland;
authors.forename: Elaine
authors.initials: E
authors.lastname: Borghi
authors.affiliation: Department of Nutrition, WHO, Geneva, Switzerland;
authors.forename: Mercedes
authors.initials: M
authors.lastname: de Onis
authors.affiliation: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC;
authors.forename: Edward A
authors.initials: EA
authors.lastname: Frongillo
authors.affiliation: Federal University of Rio Grande do Sul, Pelotas, Brazil;
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Victora
authors.affiliation: Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA;
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dewey
authors.affiliation: FAO, Rome, Italy;
authors.forename: Anna
authors.initials: A
authors.lastname: Lartey
authors.affiliation: Center for Health Research and Development, Society for Applied Studies, New Delhi, India;
authors.forename: Nita
authors.initials: N
authors.lastname: Bhandari
authors.affiliation: Norwegian National Advisory Unit on Breastfeeding, Oslo University Hospital, Oslo, Norway; and.
authors.forename: Anne
authors.initials: A
authors.lastname: Baerug
authors.affiliation: Boston College, Chestnut Hill, MA.
authors.forename: Cutberto
authors.initials: C
authors.lastname: Garza
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D001827:Body Height; D002675:Child, Preschool; D006130:Growth Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D044342:Malnutrition / Q000150:complications; D008403:Mass Screening / Q000379:methods*; D012016:Reference Values; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*; D014944:World Health Organization
keywords: growth faltering; growth velocity; linear growth; malnutrition screening; stunting prevention; weight increments