Have you ever received remarks from family members or friends that your child looks skinny?
Even though globally, the prevalence of childhood obesity is growing rapidly, undernutrition still persists as a problem in many countries, including Malaysia.
Undernutrition in children is divided into four broad medical categories: stunting, underweight and thinness, wasting, and deficiencies in vitamins and minerals.
However, the general term “skinny” is often used to refer to what is medically defined as thinness (low body mass index or BMI for age), underweight (low weight for age) and wasting (low weight for height).
In Malaysia, the National Health and Morbidity Survey (NHMS) 2015 found that around 8% of those aged below 18 had both thinness and wasting, while 13% were underweight.
In the same survey, boys and younger children (aged five to nine years old) were found to be most affected by both thinness and underweight.
Underweight can contribute to increased risk of death in children, especially when they are severely underweight.
Wasting, on the other hand, can lead to poor functioning of the immune system, making children more susceptible to infectious diseases.
In addition, deficiencies in vitamins and minerals due to underweight and wasting can also affect the normal growth of the child.
It is recommended to monitor your child’s growth and development regularly, so do measure their weight and height to calculate their BMI (weight in kilogrammes divided by height in metres squared).
Then, use the appropriate growth reference chart (BMI-for-age chart) to find out if their BMI falls in the normal, underweight or overweight range.
Consult with your healthcare professional if your child’s BMI-for-age does not fall in the normal range, or if there are other worrying signs, such as sudden loss of appetite or severe loss of weight.
Tips for parents
Here are a few tips on how to encourage your child to eat more if he or she is underweight for their age and/or height:
• Make foods appealing
Visually attractive foods are usually more appealing to our taste buds. Hence, be creative by experimenting with various shapes and colours of the foods you serve your child.
• Small but frequent
Provide meals frequently throughout the day, but in small portions. This can encourage your child to eat more and increase their total food intake. Remember to provide a balanced, moderate and varied diet.
• Dine together
Make it a norm to have meals together. Even if your child lacks appetite, make them stay at the table by having conversations with them. Children often see their parents as role models, so do not watch tv or use any gadgets during mealtimes.
• Shop and prepare foods together
Bring your child along when you go grocery shopping and ask him to pick a fruit or vegetable to be included in family meals. Children tend to be more interested in foods when they are involved in food preparation, so get them to help out, such as by washing the vegetables or arranging the plates and utensils on the dining table.
• Encourage exercise
Balance your child’s food intake with regular physical activity. Apart from building their appetite, exercise can also strengthen bones, build muscles, and improve heart health (it’s never too early to start!).
• Monitoring and consultation
Keep track of your child’s growth (i.e. their height and weight) at least every six months, as well as their developmental milestones. If you have any concern with their growth, consult the doctor immediately.
Doctors may prescribe undernourished children with high calorie milk to supplement their diet. However, be sure to clarify with your doctor/dietician on the duration and quantity of the supplement as over-feeding of high calorie milk may lead to obesity in the future.
In addition, calorie-dense foods such as potatoes, wholegrain cereals, eggs and nuts can also be included in the diet to meet the growth demands of the child. Steady, continuous growth in a child is important, so make sure you always inculcate healthy eating and active living in the family.
You can also consult a nutritionist to plan your child’s calorie and nutrient intake accordingly to achieve optimum growth. A close collaboration between parents and experts, starting from growth tracking and diagnosis to diet management is crucial for the child’s well-being.