Prevalence, trends, and associated factors of growth faltering among children in Bambaradeniya MOH area

Abstract

Rural communities in Sri Lanka face heightened nutritional vulnerability, particularly during the 2022 economic crisis. However, community-based evidence on infant growth patterns in these settings remains limited. This study aimed to investigate the prevalence, trends, and factors associated with growth faltering among children aged 0 – 18 months in the Bambaradeniya MOH area. Anthropometric and demographic data were collected from Child Health Development Records and through interviews with caregivers at polyclinics. Weight-for-age Z-scores (WAZ) from birth to 18 months were analysed, with growth faltering defined as a decline of more than 0.25 standard deviation in WAZ from birth. Descriptive statistics, trend analysis, and multivariate logistic regression were used to examine growth patterns and associated factors. This study included 386 children. Growth faltering occurred in 38.1% of the sample, with the highest prevalence observed in the 12 – 18 months age group (44.8%). During the first year, the prevalence was similar in infants aged 0 – 6 months (36.6%) and 6 – 12 months (36.8%). Most growth faltering cases (90.5%) had an onset within the first four months of life. The mean and median WAZ scores fell below the WHO standards across the low, normal, and overweight birth weight categories, without evidence of catch-up growth. Multivariate logistic regression identified three significant factors associated with growth faltering: low birth weight (odds ratio [OR]: 0.09, 95% confidence interval [CI]: 0.03 - 0.33, 𝘱 < 0.001), low household income (OR: 2.95, 95% CI: 1.01 - 8.56, 𝘱 = 0.047), and age less than four months (OR: 21.36, 95% CI: 11.07 - 41.19, 𝘱 < 0.001). Other sociodemographic variables, including maternal age, employment, education, infant sex, and birth order, were not significantly associated with growth faltering. These findings highlight the burden of early growth faltering in rural Sri Lanka and underscore the need for targeted nutritional interventions in vulnerable populations.