Growth patterns in early childhood are determined by multiple factors, the most crucial of which are nutrition and infectious disease. The height-for-age of children at birth in low- and middle-income countries is slightly below the WHO Child Growth Standards, and this declines steeply by 24 months of age. This decline is greatest for children in South Asia and sub-Saharan Africa. The pattern of weight-for-length also differs greatly by region. In this presentation, Prof Black provided an overview of factors contributing to childhood stunting, including maternal height, short birth interval and conditions during pregnancy. These factors contribute to foetal growth restriction and premature delivery. Highly prevalent in Asia and Africa, small for gestational age (SGA) rate is strongly associated with foetal growth restriction. In spite of regional variations, approximately 20% of stunting could be attributed to SGA. Diarrhoea and other infectious diseases may also be associated with stunting. Nevertheless, these effects can be moderated by adequate diet achieved through breastfeeding, appropriate complementary feeding practices and high dietary diversity.