Stunting affects 165 million children under 5 years of age around the world, and it can trap those children in a vicious cycle of poverty and undernutrition. Yet, key interventions when delivered during a critical 1,000-day window – during the mother’s pregnancy and before a child turns 2 ‒ can lead to a reduced prevalence of stunting. This report showcases new developments in nutrition programmes and analyses progress towards reducing undernutrition. It also includes case studies from countries where nutrition has been improved at scale.

Key messages include:

• Globally, about one in four children under 5 years old are stunted (26 per cent in 2011). An estimated 80 per cent of the world’s 165 million stunted children live in just 14 countries.

• Stunting and other forms of undernutrition reduce a child’s chance of survival, while also hindering optimal health and growth. Stunting is associated with suboptimal brain development, which is likely to have long-lasting harmful consequences for cognitive ability, school performance and future earnings. This in turn affects the development potential of nations.

• In tackling child undernutrition, there has been a shift from efforts to reduce underweight prevalence (inadequate weight for age) to prevention of stunting (inadequate length/height for age). There is better understanding of the crucial importance of nutrition during the critical 1,000-day period covering pregnancy and the first two years of the child’s life, and of the fact that stunting reflects deficiencies during this period. The World Health Assembly has adopted a new target of reducing the number of stunted children under the age of 5 by 40 per cent by 2025.

• In addition to the quality and frequency of infant and young child feeding and the incidence of infectious diseases, the mother’s nutrition and health status are important determinants of stunting. An undernourished mother is more likely to give birth to a stunted child, perpetuating a vicious cycle of undernutrition and poverty.

• A stunted child enters adulthood with a greater propensity for developing obesity and chronic diseases. With increasing urbanization and shifts in diet and lifestyle, the result could be a burgeoning epidemic of such conditions in many low- and middle-income countries. This would create new economic and social challenges, especially among vulnerable groups.