Stunted growth, also known as stunting or linear growth failure, is defined as impaired growth and development manifested by low height-for-age. It is a primary manifestation of malnutrition (or more precisely chronic undernutrition) and recurrent infections, such as diarrhea and helminthiasis, in early childhood and even before birth, due to malnutrition during fetal development brought on by a malnourished mother. The definition of stunting according to the World Health Organization (WHO) is for the "height-for-age" value to be less than two standard deviations of the median of WHO Child Growth Standards. Stunted growth is usually associated with poverty, unsanitary environmental conditions, maternal undernutrition, frequent illness, and/or inappropriate feeding practice and care during early years of life. As of 2020, an estimated 149 million children under 5 years of age, are stunted worldwide. More than 85% of the world's stunted children live in Africa and Asia. Once established, stunting and its effects typically become permanent. Stunted children may never regain the height lost as a result of stunting, and most children will never gain the corresponding body weight. Living in an environment where many people defecate in the open due to lack of sanitation, is an important cause of stunted growth in children, for example in India. Stunted growth in children has the following public health impacts apart from the obvious impact of shorter stature of the person affected: Greater risk for illness and premature death Delayed neurocognitive development and therefore poorer school performance and later on reduced productivity in the work force Reduced cognitive capacity Future risk of obesity Women of shorter stature have a greater risk for complications during child birth due to their smaller pelvis, and are at risk of delivering a baby with low birth weight Stunted growth can even be passed on to the next generation (this is called the "intergenerational cycle of malnutrition") The impact of stunting on child development has been established in multiple studies.