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Supplemental calories and a nurturing environment are both needed for optimal physical recovery from malnutrition. When both components are provided, most children demonstrate remarkable growth catch-up after malnutrition. Adequate dietary amino acids, phosphorus, and sulfur are particularly important to promote growth recovery. The velocity and amount of catch-up vary depending on many factors: the age of the child, the severity, duration, and cause of the malnutrition, and concurrent health problems.

Children who suffer substantial malnutrition in early childhood likely end up shorter and lighter (and with smaller head circumferences) than their genetic potential indicates (similar to most studies of intrauterine growth -- retarded infants). In some circumstances, children may achieve their full growth potential or nearly so. If the height deficit is less than 5-8%, chances for a complete recovery are good. If the height deficit is equal to or greater than 15%, the possibility of achieving normal height is less. Weight usually recovers prior to height.

Onset of puberty may be affected by malnutrition. Girls with a history of malnutrition often have significant delays in onset of menarche (first occurrence of menstruation), although precocious puberty may occur in children after recovery from malnutrition. Twelve-year-old children born small for gestational age have increased adrenocortical and adrenomedullary hormones; some have elevated cortisol and cholesterol levels.


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