Did you know that according to the National Health and Morbidity Survey, the prevalence of stunting in children under five years of age in Malaysia has increased from 17.2% (2006) to 20.7% (2016)1? That’s basically 1 in 5 children!
What Is Childhood Stunting?
Stunting generally means the failure to reach full potential for growth. The World Health Organisation (WHO) defines stunting as “the impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation”.
What Causes Childhood Stunting?
If a child’s “height for age” value is less than two standard deviations from the WHO Child Growth Standards median, he is defined as stunted2 (see Appendix A and B for WHO Child Growth graphs).
Childhood stunting can be caused by many factors, but here are the common ones in Malaysia, as elaborated by Dr Nazrul Neezam, Paediatric Gastroenterologist & Hepatologist:
- Poor nutrition/feeding
Children require an adequate amount of calories and vital nutrients to grow well and healthy. The lack of vital nutrients will not only affect children’s growth but also weaken their immune system.3
- Poor nutrient absorption
Credit: iStock
Indigestion, bacterial overgrowth and the body’s inability to absorb nutrients are known to affect children’s growth. These are the root causes of illnesses such as paediatric gastro-oesophageal reflux disease (GERD) that causes vomiting and indigestion among children, and Celiac disease that slows down bowel movements which leads to increased bacterial concentration. Acute diarrhoea that is caused by a bacterial/viral infection or inflammation of the gut also affects children’s growth. This leads to problems such as weight loss, nutrient loss and abdominal pain, too.3
- Inability to utilise nutrients
The lack of hormones will cause the body to have difficulties in absorbing nutrients effectively. Though uncommon, children who are diagnosed with hyperthyroidism, for example, do not produce enough thyroid hormones in their bodies that are needed to maintain a good metabolism function. These children may suffer not only from stunted growth but also delayed puberty, delayed tooth eruption as well as poor mental development.3
Other factors include adolescent pregnancy, poor maternal nutrition, poverty which leads to limited healthcare access and healthy food supply, poor sanitation and lack of stimulation from parents and caregivers.2,4
Long-term Impacts of Stunting
Stunting is largely irreversible2, so never take it lightly. Do note that while children can regain weight, they can never recover the same way with their height.1 Below are the long-term impacts of childhood stunting:
- Delayed cognitive and physical development2
- Impaired mental abilities, which affects learning capacities2
- Poor performance at school2
- At the risk of developing chronic diseases2
Children who are suffering from the impacts of stunting basically do not get to enjoy a healthy and happy childhood, and as a result, will have a huge impact on their livelihood in the future.
How Do You Prevent Childhood Stunting?
Now that you have understood the severity of childhood stunting, it’s imperative that you take preventive measures from day 1. We know by now that poor nutrition is the main cause of stunting among children, so what you need to do to prevent early stunting is first and foremost, practise good feeding.
Provide your child with complete and balanced nutrition daily. The easiest way to ensure that your child gets an adequate amount of calories and nutrients daily is to follow the Ministry of Health Malaysia’s healthy plate guideline5, a.k.a #quarterquarterhalf. This helpful guideline recommends children eat a variety of food groups daily by filling their plate with ¼ protein, ¼ carbohydrates and ½ fruits and vegetables.
Credit: The Malaysian Healthy Plate by Ministry of Health Malaysia
In order to instil good eating habits in your child, you can also limit mealtimes to 20-30 minutes only, encourage self-feeding (just tolerate the mess, mummy!), avoid distractions a.k.a no gadgets during mealtimes, never use food as a reward, introduce new foods every week, encourage their appetite by serving 3 meals and 2 snacks a day, and lastly, reward good behaviour and practise time-out should they misbehave.
Credit: iStock
Next, encourage your child to enjoy an active lifestyle. Bring them outdoors to play and exercise their muscles. Exercise is good for growing children because it makes them stronger and healthier, encourages them to socialise with their peers, improves their self-esteem, lowers stress and supports their healthy growth and development.
Credit: iStock
Now, remember when we said never take childhood stunting lightly? Well, it’s now super easy for any parent to track their children’s growth, thanks to the PediaSure GrowthCam filter!
Children can achieve 60% of final adult height by age of five6 yet, 1 in 5 children in Malaysia are stunted.1 Therefore, it is important for you to track and monitor your child’s height more regularly and pay attention to nutrition during the first five years of life, which is known as the golden window for growth.
Support Your Child’s Optimal Growth With PediaSure
To further support your child’s growth, why not amp up his daily nutritional needs with PediaSure, the complete and balanced nutrition for children that has been scientifically proven for 50%* faster growth in children and lesser sick days.7
*Alarcon PA, et al. Effect of oral supplementation on catch-up growth in picky eaters. Clin Pediatr (Philia). 2003;42(3):2019-17. 50% is based on calculated value.
PediaSure is formulated with Arginine, Natural Vitamin K2 and Calcium for longer and stronger bones.8,9
Measure your child’s growth against their gender and age in seconds, with the new Pediasure GrowthCam filter, accessible at https://pediasure.com.my/. You can do this at a monthly interval, at the comfort of your own home!
See how PediaSure can help Malaysian kids stand taller at www.standtallerwithpediasure.com.
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REFERENCES
- National Health and Morbidity Survey 2019: Factsheet. Available from: https://mpaeds.my/wp-content/uploads/2020/05/5.-Fact-Sheet-NHMS-2019-English.pdf Last accessed 2 July 2020.
- Stunting in a Nutshell. Available from: https://www.who.int/news/item/19-11-2015-stunting-in-a-nutshell
- Belajar & Cegah Kanak-Kanak Daripada Terbantut. Available from: https://mypositiveparenting.org/ms/2016/06/26/belajar-dan-cegah-kanak-kanak-daripada-terbantut/
- Stunting: What Is It and What It Means. Available from: https://www.concernusa.org/story/what-is-stunting/#:~:text=Some%20common%20factors%20linked%20to,for%20children%20and%20their%20mothers
- Panduan Pinggan Sihat Malaysia. Available from: https://www.moh.gov.my/index.php/pages/view/2414?mid=891
- WHO Growth Standards, 2007.
- Huynh DTT et al. 5th International Conference on Nutrition & Growth 2018. Oral nutritional supplementation improved linear growth in Filipino children at nutritional risk.
- Van Vught AJ et al. Dietary arginine and linear growth: The Copenhagen school child intervention study. Br J Nutr (2013), 109, 1031-1039.
- Van Summeren MJ et al. Vitamin K status is associated with childhood bone mineral content. Br J Nutr (2008), 100, 852-858.
APPENDIX A
HEIGHT-FOR-AGE (BOYS)
HEIGHT-FOR-AGE (GIRLS)
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