WHILE the majority of Malaysian children and adolescents are growing normally, childhood stunting remains a concern for some.
Based on the National Health and Morbidity Survey (NHMS) 2022, stunting affects 1 in 5 (21.2 per cent) of children in Malaysia.
NHMS2022 also notes that 6.8 per cent of our adolescents are stunted.
Stunted children tend to fall sick more often, miss opportunities to learn, perform less well in school, and have lower self-esteem.
They are also at risk of becoming stunted in adulthood — a condition that is associated with an increased risk of chronic diseases, decreased economic productivity, and lower lifetime-earning potential.
Growth faltering can occur at any time during childhood and adolescence.
Over time, these children may never be able to recover their height and end up becoming permanently stunted adults.
Good eating practices, optimal nutrition and regular growth monitoring are three ways in which stunting can be curbed. It's also important for the problem to be detected early and addressed.
If a child is found to be stunted or at risk of stunting, the next step would be to find out the underlying cause.
FOOD FOR THOUGHT
Common causes include not having enough nutrition, having enough food but not balanced nutrition, underlying medical conditions or a combination of these factors, says IMFeD For Growth Programme chairman Professor Dr Lee Way Seah.
"Many children have feeding difficulties, ranging from picky eating to other more severe conditions. Correcting feeding difficulties at a young age is important because it may have a long-lasting impact on a child's development or growth," says Dr Lee.
Some children may be eating well but not eating the right food. For example, their diet may be overly focused on carbohydrates, but lacking in vitamins and minerals essential for growth.
We need to nip stunting in the bud, adds Dr Lee. When children do not receive adequate nutrition, their growth rate slows down.
Malaysian Paediatric Association president Dr Selva Kumar Sivapunniam says it's always best to have a trained professional assess the growth of a child.
"Growth and nutrition issues are often very subtle and easy for a layperson to miss," he says.
SHORTER THAN NORMAL
Consultant paediatrician and paediatric cardiologist Dr Yong Junina Fadzil agrees with Dr Selva.
However, when doctors inform parents that their child is small for his or her age, parents blame it on the child's genes, she says.
They insist the child is short because he follows people in the family who are also short.
Dr Yong says in truth, only about 20 per cent of children, who are short, can lay the blame on genes. It has a lot more to do with diet.
The Covid-19 pandemic also significantly affected Malaysian eating habits.
Dr Yong says during lockdowns, with lost jobs and pay cuts, many families found their incomes had shrunk.
They couldn't afford certain foods anymore or couldn't afford to buy them in the amounts they used to, and children were heavily impacted by this shift.
People started feeling down as well and this too affected eating habits.
The fact that many Malaysian children skip breakfast is not a good thing either, points out clinical dietitian Rozanna M Rosly.
Due to starting the morning in a rush or having to wake up too early to go to school, children are less inclined to have a proper breakfast and this deprives them of important nutrients from the first and crucial meal of the day, she says.
"For children, we always advise to take small meals throughout the day which are nutrient-dense, not calorie-rich. These meals must be well-balanced too," says Rozanna.
Parents shouldn't overfeed in one meal because the child skipped the previous meal, she explains.
Clinical psychologist Professor Dr Firdaus Mukhtar says the impact of stunting is not just physical but psychological too.
These children will face mental health problems like depression and anxiety because they are different from their peers.
Their self-esteem will be affected as they compare themselves with taller children in their peer group.
"They may feel inferior, less capable and less confident, especially during school activities or social interaction," says Firdaus.
This will ultimately affect their academic performance too.
KEEPING WATCH
GROWTH Watch Month 2023 has been launched to bring together healthcare professionals and parents to prevent stunting in children and adolescents.
A major highlight of Growth Watch Month 2023 will be the IMFeD For Growth Annual Screening Campaign for children happening from August to November 2023 at all IMFeD clinics listed on https://clinics.imfed.my/.
During the 2018-2020 screening campaigns, among children aged 1 to 5, 16.1 to 17.6 per cent were found to be stunted and 8.9 to 10.8 per cent were underweight. Those at risk of stunting stood at around 20 per cent, and risk of being underweight was 19 to 23 per cent. IMFeD has screened 127,000 children since 2018.
