Pesticide exposure within the early-life exposome: a potential contributor to child undernutrition in Latin America

Despite decades of nutritional interventions, stunting continues to affect many children across Latin America, particularly in settings where rural poverty, food insecurity, and limited access to health services converge. Although its prevalence has declined in recent decades, it still disproportionately affects children living in rural, Indigenous, and socioeconomically disadvantaged communities. Child nutrition strategies appropriately emphasize diet, caregiving, infection, and socioeconomic deprivation; however, environmental toxicants are still too often treated as peripheral rather than biologically active contributors to growth faltering. In Latin America, pesticide exposure has been described in agricultural settings characterized by informal employment, limited income, and gaps in social and healthcare protection. We propose that environmental pesticide exposure is a neglected yet biologically plausible contributor to child undernutrition that warrants greater consideration in research addressing the environmental determinants of child growth. Rather than acting as an isolated determinant, pesticide exposure should be understood as one component of the early-life exposome, interacting with nutritional, infectious, social, and environmental conditions that jointly shape child growth. In agricultural and socioeconomically vulnerable settings, pesticide exposure may coexist with poverty, household food insecurity, maternal undernutrition, limited dietary diversity, unsafe water and sanitation, recurrent infections, limited access to healthcare, and exposure to other environmental contaminants. These complex and potentially interacting determinants may partly explain the heterogeneity of the available epidemiological evidence and should be explicitly considered in future longitudinal studies evaluating pesticide exposure and child growth.