PE2.1-3 | Growth Problems — Glossary

A ratio or comparison of two body measurements — e.g., weight-for-age, weight-for-height, height-for-age — expressed as z-scores relative to the WHO reference population; used to classify the type and severity of undernutrition.

An estimate of skeletal maturation based on the degree of ossification and epiphyseal fusion in a left-hand and wrist X-ray, interpreted using the Greulich-Pyle atlas; normally equals chronological age within ±2 years.

A normal variant characterised by delayed bone age, normal growth velocity for bone age, delayed onset of puberty, and a family history of delayed puberty; final adult height is within the genetic target range.

India's MOHFW-NHM protocol for outpatient management of uncomplicated SAM using RUTF and weekly follow-up at health facilities or Anganwadi centres.

Short stature in which limb length is abnormal relative to trunk height, indicating a skeletal dysplasia (e.g., achondroplasia); identified by measuring sitting height and arm span.

The cartilaginous zone at the ends of long bones where chondrocyte proliferation drives longitudinal bone growth; stimulated by GH/IGF-1 and thyroid hormone; fuses under oestrogen influence at the end of puberty, ending linear growth.

WHO therapeutic milk formula providing 100 kcal and 2.9 g protein per 100 mL, used in the rehabilitation phase of SAM once complications resolve and appetite returns.

WHO therapeutic milk formula providing 75 kcal and 0.9 g protein per 100 mL, used in the stabilisation phase of SAM management to prevent refeeding syndrome.

A pattern of inadequate physical growth in a child, typically defined as weight-for-age < −2 SD on the WHO growth chart or crossing ≥2 centile lines downward; a clinical sign rather than a diagnosis.

A normal variant in which the child is short because of genetic inheritance from short parents; bone age equals chronological age, growth velocity is normal, and height is within the mid-parental height target range.

A dynamic test to diagnose GHD; GH secretion is stimulated pharmacologically (e.g., with insulin, arginine, clonidine) and peak GH is measured; a peak <10 ng/mL (or <7 ng/mL in some protocols) is diagnostic of deficiency.

A radiographic reference atlas for bone age estimation based on left-hand and wrist X-rays; widely used clinically though derived from a North American population, which may slightly overestimate maturation in Indian children.

Inadequate secretion of growth hormone from the anterior pituitary, leading to short stature (growth velocity <4 cm/yr), delayed bone age, low IGF-1, and a peak GH <10 ng/mL on stimulation testing; treated with daily subcutaneous rhGH.

The rate of linear height gain over a measured period (usually 6–12 months), expressed in cm/yr; a prepubertal growth velocity below 4 cm/yr is a red flag for pathological short stature.

Compares a child's height to the expected height for their age; a z-score < −2 SD = stunting, reflecting chronic undernutrition or repeated episodes of illness and inadequate diet.

Standard formula for calculating daily maintenance fluid requirements: 100 mL/kg/day for first 10 kg body weight, 50 mL/kg/day for the next 10 kg, and 20 mL/kg/day for each additional kilogram above 20 kg.

A peptide hormone produced primarily by the liver in response to GH stimulation; mediates GH's growth-promoting effects at the epiphyseal plate; low levels in GHD, GH resistance, and malnutrition.

A form of severe acute malnutrition characterised by bilateral pitting pedal oedema, generalised oedema, skin changes (flaky paint dermatosis), and hair changes, due to predominant protein deficiency; the oedema may mask weight loss.

Severe acute malnutrition characterised by extreme wasting (weight-for-height < −3 SD) without oedema, resulting from severe caloric deficiency; the child appears 'skin and bone' with a wizened face.

The genetic target height calculated from parental heights: boys = (father + mother + 13)/2; girls = (father + mother − 13)/2; the target range is MPH ± 8.5 cm.

Undernutrition defined as weight-for-height between −2 and −3 SD, or MUAC 11.5–12.5 cm; managed with supplementary feeding in the community.

Circumference measured at the mid-point of the left upper arm; a rapid, field-appropriate screen for acute malnutrition: <11.5 cm = SAM, 11.5–12.5 cm = MAM, in children aged 6–59 months.

Failure to thrive in the absence of an identifiable organic disease, resulting from inadequate caloric intake due to feeding practices, psychosocial factors, poverty, or caregiver mental health problems.

A facility-based centre under India's NHM providing inpatient care for children with SAM with medical complications; provides F-75/F-100 protocol, micronutrients, and caregiver education.

Failure to thrive caused by an underlying medical condition that impairs nutrient intake (e.g., GERD), absorption (e.g., coeliac), or increases metabolic demand (e.g., CHD, TB).

Short stature in which limb and trunk measurements are in normal proportion; most pathological endocrine, nutritional, and systemic causes produce proportionate short stature.

A reversible form of functional GH deficiency caused by severe emotional deprivation; GH secretion normalises when the child is placed in a nurturing environment, demonstrating the hypothalamic sensitivity to psychosocial stress.

Synthetic growth hormone administered as a daily subcutaneous injection at 0.025–0.035 mg/kg/day for GHD; also approved for Turner syndrome, SGA without catch-up, and other conditions at specific dosing protocols.

A potentially fatal metabolic complication of rapid reintroduction of nutrition in a severely malnourished child, characterised by acute shifts in phosphate, potassium, and magnesium; prevented by the gradual F-75 approach in SAM stabilisation.

A modified oral rehydration solution with lower sodium (45 mmol/L vs 75 in standard ORS) and added potassium and magnesium; used to rehydrate children with SAM to avoid precipitating oedema.

A feeding approach in which the caregiver pays attention to the child's hunger and satiety cues, feeds in a calm and positive environment, and responds to feeding difficulties with patience rather than force.

A peanut-based, energy-dense paste (e.g., Plumpy'Nut, ~500 kcal/92 g sachet) used for community-based management of uncomplicated SAM; does not require water, reducing contamination risk.

The most serious form of acute undernutrition, defined by any of: weight-for-height < −3 SD, MUAC <11.5 cm (6–59 months), or bilateral pitting pedal oedema; associated with high mortality without treatment.

Birth weight and/or length below −2 SD for gestational age; children who fail to achieve catch-up growth by 2–4 years of age may have persistent short stature and are candidates for rhGH therapy.

Height-for-age below −2 SD from the mean for age and sex on the WHO/IAP growth chart; a clinical sign requiring identification of cause rather than a diagnosis in itself.

A group of genetic disorders affecting bone and cartilage development, producing disproportionate short stature; includes achondroplasia (commonest, FGFR3 mutation), hypochondroplasia, and others.

Height-for-age below −2 SD, reflecting chronic or repeated undernutrition, recurrent illness, or inadequate care in early life; the most prevalent form of short stature in India, attributable primarily to nutritional deficiency.

A chromosomal condition (most commonly 45,X or mosaic 45,X/46,XX) affecting females, characterised by short stature, gonadal dysgenesis (primary amenorrhoea), and variable dysmorphic features (webbed neck, wide carrying angle, shield chest); diagnosed by karyotype.

Compares a child's weight to what is expected for their height, reflecting acute undernutrition; the key index for classifying SAM (< −3 SD) and MAM (−2 to −3 SD).