MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia,
Nestle Nutr Inst Workshop Ser. 2020;95:33-40. doi: 10.1159/000511514. Epub 2020 Nov 9.
The great majority of attention on growth faltering concentrates on the first "1,000 days" with a much lesser focus on toddlers and young preschoolers. The rationale for this is understandable since the first 1,000 days cover the period of most rapid growth and changes in body composition, the period of breastfeeding, and the complex transition from breastfeeding and weaning to complementary feeds, and then moving to the family/adult diet. There has also been a strong perception that, once a child has become stunted or wasted in the first 2 years of life, there is little hope of recovery, an assumption we address below. This paper will describe the timing of the development of stunting and wasting, addressing 3 critical periods: intergenerational, in utero, and early postnatal life. The question of whether toddlers and young preschoolers can recover from stunting and wasting will also be addressed; our own studies suggest that a degree of recovery is certainly possible. The hormonal mechanisms regulating early growth will be examined. Finally, the issue of whether toddlers and young preschoolers should have special foods and diets will also be discussed.
绝大多数关于生长迟缓的关注都集中在前“1000 天”，而对幼儿和幼儿期的关注则少得多。这样做的理由是可以理解的，因为前 1000 天涵盖了身体成分增长最快、母乳喂养、从母乳喂养和断奶到补充喂养的复杂过渡，以及向家庭/成人饮食过渡的时期。人们还强烈地认为，一旦儿童在前 2 年的生命中出现生长迟缓或消瘦，恢复的希望就很小，我们将在下面讨论这一假设。本文将描述生长迟缓和消瘦的发展时机，涉及三个关键时期：代际、宫内和出生后早期。还将讨论幼儿和幼儿期是否可以从生长迟缓和消瘦中恢复；我们自己的研究表明，一定程度的恢复是完全有可能的。将检查调节早期生长的激素机制。最后，还将讨论幼儿和幼儿期是否应该有特殊的食物和饮食。
