The Malaysian Paediatric Association (MPA) has launched “IMFeD Get Growth On Track”, its first nationwide childhood growth screening and counselling campaign, and for good reason, too.
MPA’s member paediatricians are becoming increasingly concerned over the fact that many Malaysian children, from all family backgrounds, are experiencing growth problems.
According to the National Health and Morbidity Survey 2016: Maternal and Child Health, one in five Malaysian children under five years old is stunted (short for age) and one in 10 is underweight.
Without intervention, these children risk developing long-term health, cognitive and psychosocial issues.
It is an alarming situation but MPA hopes to make a difference. With the support and collaboration of Abbott Malaysia, the association has deployed the IMFeD Expert Panel to train over 150 paediatricians from all over the country in the detection and management of growth problems.
The Expert Panel has also produced educational materials containing vital information and tips for parents.
Now, MPA is inviting parents to consult the paediatricians to detect growth problems early, overcome the contributing risk factors, and set the children on a healthy growth trajectory that will see them attain their potential.
What can parents expect on their first visit?
Here is a glimpse from consultant paediatrician and IMFeD Expert Panel member, Dr Anna Padmavathy Soosai, and Nur Ain Afiqah Bt Ahmad Zabidi, mum to one-and-a-half year old Muhammad Emir Haider Bin Mohamad Harith.
Q: Nur Ain, why did you decide to consult Dr Anna about Emir’s growth?
Nur Ain: I was anxious because Emir was a picky eater and took excessive amounts of milk which ruined his appetite for normal meals. Dr Anna said all this had caused him to be underweight and advised me on how to help him grow better. I am very happy to see Emir improving now.
Q: Dr Anna, how did you examine Emir?
Dr Anna: As paediatricians, we know that just looking at children will not enable us to reliably ascertain whether they are growing well or not. Instead, we need to take their weight and length, and plot the measurements onto growth charts.
Readings falling below the normal range as well as irregular growth patterns are red flags that signal growth problems. In Emir’s case, the charts clearly showed that he was underweight.
Q: What else did you do?
Dr Anna: My nurse had gotten Nur Ain to complete a simple questionnaire about Emir’s feeding behaviour, who feeds him, what foods he eats, his sleep habits, physical activity and other important areas.
We also enquired into (and ruled out) other contributing factors, such as being frequently unwell in the first few years of life, the presence of chronic disorders, prolonged exposure to certain medications, or being born prematurely.
Nur Ain’s responses enabled me to identify the factors that were impeding his growth. After that, we worked out an intervention plan to address Emir’s needs.
Q: What would a typical intervention plan look like?
Dr Anna: Such a plan would contain recommendations directed at the child as well as the parent or carer. It would probably include suggestions on foods to give, feeding methods, tips for sound sleep (children grow the most during night time sleep) and physical activity, and even parenting approaches.
Q: What is the most important factor to emphasise?
Dr Anna: Nutrition, of course. It is the cornerstone of growth. It is responsible for the formation of new bone tissue that causes long bones (eg in the legs) to elongate, thereby resulting in the child growing taller.
Despite the importance of nutrition, I find that many parents aren’t sure what foods to offer, how much and how often. It is crucial to introduce new foods to children and ensure good variety. Failure to do so may increase the likelihood of feeding difficulties.
Q: Would poorly growing children need special foods?
Dr Anna: In most cases, we can get growth back on track by giving children better diet quality, or enriching the nutritional value of their daily foods.
However, there are times when it might be necessary to also prescribe oral nutritional supplementation for children who require additional energy and complete balanced nutrition for catch-up growth.
Q: Nur Ain, how would you feel about recommending the IMFeD Get Growth On Track campaign to other mums?
Nur Ain: I found the process very simple and clear. I became more aware of Emir’s growth; whereas I did not have any idea about his weight and height, I know his vital statistics now!
Just as important, I have learned more about growth problems and how to overcome them. Lastly, I appreciate how Dr Anna has asked to see Emir again after three months, to monitor his progress. So, all in all, I am very satisfied with this campaign. So I would definitely recommend it to other mums.
Q: Dr Anna, a final message?
Dr Anna: Some parents are oblivious to their children’s growth problems. Others may misinterpret growth problems – for instance, believing it is normal for their children to be stunted simply because they themselves are short.
In either case, these parents fail to identify the risk factors and miss the opportunity to intervene in a timely and effective manner.
As a result, their children (including those of normal height and weight today) may not be able to overcome the barriers impeding their growth, and end up shorter or lighter than expected over time. I would like to urge all parents, especially those with children under five years old, to take advantage of the IMFeD Get Growth On Track as soon as possible.
Do not delay because the earlier we detect growth problems, the sooner we can correct them.