The CDC uses the 2.3rd percentile (for birth to 24 months of age) and the 5th percentile (for 2-5 years of age) stature-for-age, as the cut-offs to define short stature in its Pediatric Nutrition Surveillance System (1, 2). However, CDC does not have a position regarding the cut-off percentile which should be used to determine at risk of short stature as a nutritional risk in the WIC Program. At risk of short stature is included in this criterion to reflect the preventive emphasis of the WIC Program.
Abnormally short stature in infants and children is widely recognized as a response to an inadequate nutrient supply at the cellular level (4). This indicator can help identify children whose growth is stunted due to prolonged undernutrition or repeated illness (3). Short stature is related to a lack of total dietary energy and to poor dietary quality that provides inadequate protein, particularly animal protein, and inadequate amounts of micronutrients such as zinc, vitamin A, iron, copper, iodine, calcium, and phosphorus (4). In these circumstances, maintenance of basic metabolic functions takes precedence, and thus resources are diverted from linear growth.
Demonstrable differences in stature exist among children of different ethnic and racial groups. However, racial and ethnic differences are relatively minor compared with environmental factors (1). Growth patterns of children of racial groups whose short stature has traditionally been attributed to genetics have been observed to increase in rate and in final height under conditions of improved nutrition (5, 6).
Short stature may also result from disease conditions such as endocrine disturbances, inborn errors of metabolism, intrinsic bone diseases, chromosomal defects, fetal alcohol syndrome, and chronic systemic diseases (4).
