Growth in length of children recovering from severe malnutrition.

The linear growth of 369 children treated for severe malnutrition at the Tropical Metabolism Research Unit, University Hospital of the West Indies, was examined retrospectively. Mean age was 12.6 months and 58 per cent of the children were oedematous on admission. Mean length for age was the same at admission and discharge (SD score - 3.4). Therefore when the sample is considered as a whole there was no catch-up in length for age. A sub-group of 108 children began to show catch-up growth in length. This sub-group did not differ in age or sex from the total sample but contained a greater proportion of non-oedematous children. Children in the sub-group were also more stunted initially (P less than 0.0001) than the group as a whole. The absolute rate of linear growth was similar in oedematous and non-oedematous children. Change in length for age during recovery was significantly less in children who were oedematous on admission. Two-thirds of the children attained at least 85 per cent weight for length before they began to increase in length. Thus in most cases linear growth followed replenishment of body weight. The data point to the need for further investigations to determine why some children were capable of early catch-up growth in length while others, with similar characteristics, showed minimal or no linear growth during recovery.