|Causes and Mechanisms of Linear Growth Retardation (International Dietary Energy Consultative Group - IDECG, 1993, 216 pages)|
|Psychosocial adversity and growth during infancy|
The aim of most questions was to obtain further information on Skuse et al.'s study. James wondered if an important cause of growth faltering could have been that the mothers of stunted infants introduced inappropriate foods too early, which could have led to metabolic disturbances. Skuse replied that he and his colleagues had studied dietary intakes in all infants, but that they had found no evidence in support of this hypothesis. On the whole, slightly more of the case infants were breastfed (75% vs 60%) and on average for a longer period (5 vs 3 months) than infants without growth faltering. No important differences in dietary intakes could be found between early and late faltering infants.
There was a negative correlation between a score for minor congenital malformations and the Bayley Mental Development Index, it accounted for about 10% of the variance, but did not distinguish the groups.
The population of South London, where this study was undertaken, is composed of groups of different ethnic backgrounds. Growth faltering was more common in infants from the Indian Subcontinent than among infants of African origin. Asking the parents whether they had wanted another child or not, did not result in different answers for different groups of children.
Waterlow asked Skuse what he thought of MacCarthy's (1981) idea that the hypothalamus and pituitary of neglected and malnourished infants was affected and that this led to stunting via a secondary growth hormone deficiency. According to Skuse, this could be so in cases of psychosocial dwarfism, but these are very rare.