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Concerns about nutrition and growth are common in refugee-background children, although there are no Australian population data for this group. Specific issues include low weight and/or height for age, vitamin deficiencies, iron deficiency and anaemia. Increasingly, clinicians are noting overweight/obesity as a health issue in the years after settlement,1 and there are anecdotal reports of dyslipaemia in the Afghani community and diabetes in the Karen community. The early settlement period represents a window for health promotion around nutrition.
Post-natal growth is most rapid during early infancy; then slows by the primary school years picking up again at puberty. Linear growth is similar in children aged
<5 years worldwide,2 although growth must be considered in the context of parent height, ethnicity (Australian growth charts are based on American data)3 and pubertal status. Children may have different growth parameters to their Australian born peers and still have normal growth, they may appear thinner than Australian born peers, considering 24% of Australian children are overweight/obese (2017-18 data).4
Most common causes of poor growth in refugee children are elicited with a careful history and examination.
Once the initial screen has been completed and treatment initiated as necessary, a period of monitoring growth is often appropriate.
Immigrant health clinic protocols. Author: Georgie Paxton, initial January 2014, most recent update Apr 2020. Contact firstname.lastname@example.org