Stunting in children still a problem in Malaysia

According to the National Health and Morbidity Survey (NHMS), the prevalence of stunting in children under five years of age in Malaysia has increased from 17.2% (2006) to 20.7% (2016).

These numbers show that stunting remains a public health concern, with one in five children under the age of five suffering from this condition in Malaysia.

Stunting is defined as lower-than-average height for a child’s age, which is more than two standard deviations below the World Health Organization (WHO) Growth Standard median.

Stunting is a form of chronic malnutrition that is largely irreversible and can lead to more serious problems if no measures are taken to prevent it.

Could your child be a part of this group?

Poor nutrition, poor growth

The key to tackling the issue of stunting is to know its many causes.

All the factors below can interact to hamper a child’s growth and development, leading to stunting.

• Poor maternal health and nutrition before, during and after pregnancy can hinder a child’s early growth starting from conception

Malnutrition, stunting, undernutrition,

Stunting is not always easy to identify visually, as in this filepic, but needs to be verified by checking a child’s height against the proper growth chart for their age.

• Other maternal factors, like adolescent pregnancy and short birth spacing (having children too closely to one another), can interfere with the nutrients available to the foetus.

• Poor feeding practices, including non-exclusive breastfeeding by introducing food or water too early, as well as complementary feeding that is inadequate, inappropriate for age or untimely.

• Recurrent infections and illnesses, e.g. diarrhoea, due to poor hygiene and sanitation.

• Other factors include household poverty, food insecurity, neglect and lack of stimulation from parents or caregivers, poor access to healthcare facilities, and non-responsive feeding.

Stunting is not just about being short for age.

It is also a risk factor for poor child development and can have long-term effects on individuals.

It can lead to a lag in cognitive and physical development, diminished mental ability and learning capacity, poor performance at school, and reduced productivity due to poor health in adult life.

It can also increase the stunted child’s risk of becoming overweight and obese, and lead to nutrition-related chronic diseases, like diabetes and heart disease when they are older.

Stunting also results in a weakened immune system and increases the risk of infectious diseases.

Good feeding practices

The effect of stunting is largely irreversible after the age of two years.

Choices made by parents will influence a child’s growth and developmental potential.

Thus, parents have to ensure that their children receive healthy and sufficient nutrition to prevent stunting through the following practices:

Focus on the first 1,000 days

The 1,000-day window, starting from conception until the child’s second birthday, is a critical period of growth and development.

Focusing on this period is important as growth failure often begins here.

Ensure that both mother and baby are healthy and receive sufficient nutrition during and after pregnancy.

Exclusive breastfeeding until six months of age

Optimal breastfeeding practices are the basis to a child’s healthy growth and development.

These include early initiation and frequent, on-demand, exclusive breastfeeding for six months after birth, as well as continued breastfeeding until two years of age.

Breast milk provides a complete source of nutrients and natural growth stimulators for infants, and contributes to the development of their immune systems.

Timely introduction of complementary foods

By six months of age, most infants are developmentally ready for complementary foods as breast milk alone is no longer sufficient to meet the child’s needs of energy and nutrients.

This is the right time to introduce complementary food, which has to be adequate and safe, with age-appropriate texture and preparation.

Healthy feeding practices

Introduce a variety of foods from all food groups, including plant-sourced foods (vegetables, fruits, fortified cereals) and animal-sourced foods (dairy, meat, poultry, fish and eggs) during complementary feeding.

Ensure that your child is given meals four to five times a day, and gradually increase the quantity.

Nutrient-dense foods such as milk, which is high in important nutrients that support growth, are vital to support a child’s rapid rate of growth.

Keeping track of growth

A child’s growth can be monitored by tracking their developmental milestones.

Identifying stunting visually can be difficult. Therefore, it is important to measure a child’s height and weight regularly, and compare them to the WHO growth standards.

Voice any concerns regarding your child’s growth to his or her paediatrician or family doctor.

Stunting is the most prevalent form of child undernutrition that is also preventable.

Stunting has early beginnings, but long-lasting and largely irreversible effects on the physical and cognitive development of children.

Providing children with adequate and healthy nutrition is crucial to ensure their optimal growth and development.

Dr Wong Jyh Eiin is a nutritionist and a Nutrition Society of Malaysia council member. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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