Susan writes: "While height does not always predict pelvic size, studies done in developing countries do show that significant stunting can lead to increased rates of obstructed labor." Just to clarify this post, Reynaldo Martorell's (and others') research on the long-term consequences of malnutrition in childhood leading to stunting (reduced height) in adult women and therefore to higher risk of complications in childbirth refers only to *stunting*, not to merely being short. These are two different issues. If you are 4'10" tall as an adult because of genetic factors -- both your parents and all four grandparents are very short -- but you and your parents and grandparents all grew up with excellent nutrition and very little disease, then you are not stunted, you are just short. And you are not at higher risk of obstetric difficulties, because you have a perfectly normal pelvis. You may have broad hips and a large pelvic outlet, you may have narrow hips and a large pelvic outlet. Or you may have a small pelvic outlet, regardless of the size of your hips. But you have the standard risk of obstetric difficulties based on the size of your pelvic outlet, not the broadness of your hips or your height. If you are 4'10" tall as an adult because you grew up under adverse environmental conditions, such as moderate to severe childhood malnutrition, lots of diseases, contaminated water supply, no antibiotics, no immunizations, emotional distress such as from civil war, etc. etc. etc. -- and if you and your parents and grandparents would all have been much taller if you had grown up under better circumstances, then you are stunted. And you are at higher risk of obstetric difficulties. It is the mismatch between the underlying genetic potential for height and the actual achieved height that qualifies as stunting. If you could have been 5'6" from genetic potential and are only 4'10" due to poor diet and disease and emotional stress, then you are stunted and may have a malformed pelvis with a smaller pelvic outlet due to impaired growth of the pelvis during childhood (which goes along with impaired growth in the long bones, leading to short stature) and therefore a higher risk of difficulty in childbirth. If you could have been 4'10" from genetic potential and ARE 4'10", then you are just genetically short. It can be difficult to fully grasp the degree to which stunting affects height -- many people think that the Vietnamese or the Mayans of Guatemala are all genetically short. Some of them ARE genetically short, just as any population has a range of variation in genetic potential in height, but most of them are short due to generations of poor diet, disease, and war. When you alleviate the bad environmental circumstances, the kids start to grow more normally. The younger the kid when the environment is changed for the better, the more like US growth standards they grow. It can take 2-3 genertions of good environmental conditions before the grandchildren and great-grandchildren are able to achieve their full genetic potential. Go to any mall in the US on a Sunday afternoon in a city where there are lots of relatively recent immigrants from parts of the world where environmental conditions are difficult and you can see the stair-step effect known as 'positive secular trend' -- here is grandma, born and raised in Guatemala (for example), at 4'10" tall; next is mother, born in Guatemala and brought to the US in her early teens, at 5'2" tall, and here is daughter, born and raised in the US, and already 5'6" at age 12 years. You see this all the time. Grandma was stunted, mother was somewhat stunted, daughter may still be a little stunted -- perhaps she'll end up 5'7" when her genetic potential was for 5'8". The next generation will probably max out the genetic potential, at last. Kathy Dettwyler _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html