• nutrition
• growth
• screening
• tropical paediatrics

Anthropometry, the rigorous methods used to measure the physical dimensions of the human body, is widely used in medicine and public health to identify and label individuals with suboptimal nutritional status. In paediatrics, anthropometry’s tool set and international standards are widely used throughout resource-constrained areas of the world to identify and label children with malnutrition, which is often given further descriptive labels such as ‘acute’ and ‘chronic’, ‘severe’ and ‘moderate’.

But what is often glossed over is that these various forms of malnutrition are only screened for by anthropometry—these measurements are not the disease in and of itself; they only imply risk, to guide clinical care, to generate advocacy. Anthropometric standards are but a mere proxy for nutritional status, not an end point, as they tell us surprisingly little about what really matters to clinicians and policymakers—optimal child development, which encompasses the physical, cognitive, social, linguistic and emotional development of children that begins prenatally and continues at least through primary school. While we should celebrate that childhood mortality rates continue to fall worldwide, we must be sober in our realisation that a third of all children are not developing optimally.1 As UNICEF and many others have pointed out, children are surviving but not necessarily thriving.

Nevertheless, anthropometry remains an important screening tool, and remains the best and most practical means of identifying malnourished children and guiding our management in everyday clinical practice. Even as we accept its limitations, the population of infants under 6 months of age remain most underserved and under-represented by …