Is your child at risk of Stunting?

Malaysia is a developing country that has advanced in food availability, affordability and stability. Food scarcity is not an apparent problem we face anymore. Yet, while food is secure and while most have sufficient to eat, undernutrition remains high in Malaysia.

The matter is no longer one of food quantity and accessibility but food quality.

Globally, the occurrence of stunting for kids below 5 in 2016 is 23% which is almost 3 times more prevalent than the more known problem of being overweight which is 6%.

In Malaysia itself, stunting increased from 17.2% in 2006 to 20.7% in 2016 for children under the age of 5. That makes up 1 in every 5 children being stunted in their early years of growth.

Undernutrition and overnutrition both shape development differently. For how nutrients influence growth overall, see How does Nutrition Influence a Child's Development?.

What is stunted growth?

Stunting is primarily the outcome of a child not receiving adequate nutrients since young, especially in their sensitive growing period. It is usually seen in height lost in their early years. The WHO classify stunting as when the children's height-for-age is more than two standard deviations below the WHO Child Growth Standards median.

What are the negative outcomes?

Stunting is not simply about having a shorter stature, but includes its severe irreversible outcomes.

The effects of stunting are mostly permanent despite consequential nourishments in later years. The long-term effects of stunted growth are a decreased cognitive and physical development, poor health and a higher risk for non-communicable diseases like diabetes, cardiovascular diseases and degenerative diseases.

For more on non-communicable disease risks, see What is a Non-Communicable Disease?.

Consequently, stunted cognitive growth will impair children's school performance, reduced productivity across life and even lead to lower earnings income in the future. Stunting leads to a substandard living quality.

An impaired immune system due to stunting may also give rise to greater susceptibility to contracting infectious diseases, leading to early deaths (Manan, Sundaram & Tan, 2019).

Strong immunity also depends on adequate nutrition—read Can Good Nutrition Boost the Immune System?.

What are the causes of stunted growth?

1. Maternal Health

Because stunting usually occurs among children in their first few years, the health of the mother is in view. Inadequate maternal nutrition intake before, during and after pregnancy may hamper the child's early development as early as their conception.

2. Feeding Practices

Non-exclusive breastfeeding accompanied with the introduction of food or/and water too early may lead to insufficient nutritional intake for the baby.

3. Parental Negligence

Parents may not have the awareness and knowledge to the nutritional needs of their children, especially in their critical early years. Among the many reasons, household poverty may also lead to lesser to no options for securing nutritious food. Nutritious food thus becomes a privilege for the middle and upper socioeconomic classes.

Malnutrition can also present as overnutrition. Children Obesity Awareness Month explains how poor diet quality affects Malaysian children even when calories are sufficient.

How to prevent stunted growth?

The consequences of stunting are very much irreversible after two years since birth. Therefore, parents must ensure healthy feeding practices for their infants to ensure they receive the nutrients they need.

1. Focus on the child's critical growth period.

The 1000-day window is critical for a child's development. Parents must make sure both mother and child are healthy.

2. Exclusive breastfeeding until the child is at least 6 months old.

Breast milk provides a complete source of nutrients and natural growth stimulators for infants. It also boosts the development of their immunity.

3. Timely introduction of complementary foods

By six months, most infants are ready for complementary food/human milk substitutes as breast milk alone is not adequate to meet the child's energy and nutrients needs. Parents must also ensure that the food provided is age-appropriate and safe for consumption.

4. Introduce a wide-range of food types

Include plant-based foods like vegetables, fruits and fortified cereals. Animal sourced foods should not be left out too. They include dairy products, meat, poultry, fish and eggs. It is recommended that they are fed 4 to 5 times daily with gradual increase in amount. Look out for nutrient-dense foods like milk.

5. Be conscious of growth milestones

Keep track and monitor growth milestones like height and weight as suggested by the World Health Organization regularly. Be mindful that stunting has early beginnings, but long-lasting and mainly irreversible effects.

For children who are older, parents are responsible to provide nutritious meals for their children. Convenience must not be the reason to neglect their health and nutrient needs. Parents must therefore be diligent in being aware and knowledgeable of the family's food consumption in their habitual routine.

Personalized nutrition can help families meet individual needs. See Can Personalized Nutrition Help Prevent Chronic Diseases? for how DNA insights support dietary planning.

*The article is not intended to replace any medical advice. Kindly make sure to consult a pediatrician for proper personal medical advice.

References

Manan, W., Sundaram, J. K. and Tan, Z. G. (September 2019). Addressing Malnutrition in Malaysia. Khazanah Research Institute.https://www.krinstitute.org/

United Nations Children's Fund. (n.d.). Children, Food and Nutrition: State of the World's Children 2019. https://www.unicef.org/malaysia/children-food-and-nutrition-state-worlds-children-2019

Wong. J. E. (August 2019). Stunting in children still a problem in Malaysia. https://www.thestar.com.my/lifestyle/family/2019/08/09/stunting-in-children-problem-malaysia