#HEALTH: Addressing stunting among children

CHILDREN are considered stunted when they are too short for their age. Malaysia has among the highest childhood stunting rates in the region, affecting 1 in 5 children aged 5 years and below and around 1 in 12 adolescents.

The Malaysian Paediatric Association (MPA) celebrated the 10th anniversary of its "IMFeD For Growth" programme (IMFeD) recently.

IMFeD was launched in 2012 and has been driven by a panel of different experts, including paediatricians, dietitians, and psychologists.

MPA president, Dr Selva Kumar Sivapunniam, says the first phase of the programme (2012 – 2017) revolved around the "Identification and Management of Feeding Difficulty" while the second phase (2018-2022) saw the programme expanding its scope to include growth screening and intervention for growth faltering to prevent stunting.

Stunting is a problem that can be found across both urban and rural families, irrespective of socioeconomic status.

"This is very worrying because stunting is associated with reduced immunity, cognitive impairment, as well as chronic diseases, and reduced socioeconomic opportunities in adulthood," says Dr Selva.

IMFeD For Growth programme chairman, Professor Dr Lee Way Seah, adds that of all the factors contributing to stunting in children, the most common is undernutrition.

Good nutrition is crucial to children's growth and development at all stages, especially during the formative period of 1-5 years old, and early adolescence (10-15 years).

Nutrients such as protein, calcium and vitamin D improve bone and muscle development, while micronutrients like arginine and vitamin K2 support longer and stronger bones for optimal height gain.

The IMFeD expert panel has set out to develop guidance for much-needed nutritional support for children experiencing growth faltering. Solutions range from handy tips to enhance or fortify their food, to educating parents on a variety of locally available nutritious food.

Parents also need to check on their children's growth at least once a year.

In 2018, IMFeD rolled out its childhood growth screening and counselling campaign via its network of over 200 private clinics.

This allowed participating doctors to measure children's weight and height and assess their growth status, identify risk factors if growth issues were evident, and advise parents on how to manage the situation with appropriate nutritional and lifestyle interventions.

To date, the programme has performed over 100,000 growth checks.

Dr Lee says the next phase of the IMFeD For Growth (2023-2027) will focus on three thrusts.

The first involves extending its scope from the initial 1-5 years to 1-17 years to enable IMFeD to detect and manage growth faltering wherever it may occur in childhood and adolescence. The second is capacity building.

"Healthcare professionals play a vital role in the fight against childhood stunting. They are the best guiding voices to help parents and children who may be falling behind. Thus, we plan to organise training for general practitioners, medical officers, family medicine specialists, and nurses in private and public clinics. This will help ensure that growth can continue to be prioritised in urban and rural environments, affluent and lower socio-economic settings."

The third thrust will involve amplifying the IMFeD For Growth screening and counselling campaign to benefit more children and adolescents each year.

This year's screening and counselling campaign will run from Aug to Oct 2022. Parents who are concerned about their children's growth are encouraged to consult their doctor or locate an IMFeD clinic by visiting https://clinics.imfed.my/.

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