You often receive remarks from your peers and family members that your child looks skinny. Could this be true? Globally, even with the rising prevalence of childhood obesity, undernutrition still persists as a problem including in Malaysia.
Undernutrition in children is divided into four (4) broad subforms: stunting; underweight and thinness; wasting; and deficiencies in vitamins and minerals. However, ‘skinny’ is often referred to as thinness (low BMI-for-age), underweight (low weight-for-age) and wasting (low weight-for-height).
The National Health and Morbidity Survey (NHMS) 2015 found that for children under 18, there is an 8% prevalence for both thinness and wasting, with underweight at 13%. Boys and children aged 5-9 years were found to be highest in the prevalence of both thinness and underweight.
Should you be concerned?
It is recommended to monitor your child’s growth and development regularly, by measuring the weight and height to calculate the body mass index (BMI). Then, use the appropriate growth reference chart (BMI-forage chart) to find out if the BMI falls in the normal, underweight, or overweight range. You can refer to the ‘BMI-for-age Growth Chart for Children’ infographic in the Resources section on our website. Consult with your healthcare professional if your child’s BMI-for-age does not fall within the normal range, and if there are other worrying signs such as poor appetite or severe weight loss.
What can you do if your child is skinny?
- Make food appealing. Entice him with visually attractive food. Be creative by experimenting with various shapes, colours and textures of food.
- Small but frequent. Provide meals in small portions throughout the day. This can encourage your child to eat more. Remember to have a balanced, moderate and varied diet.
- Dine together. Make it a norm to have meals together. Even if he lacks appetite, make him stay by having conversations with him. Do not watch TV or use any gadgets during mealtimes.
- Shop and prepare food together. Bring your child along when you go grocery shopping. Get him involved in making decisions on items to be included in family meals. Children tend to be more interested in food when they are involved in food preparation. Get them to help out by washing vegetables or even arranging the plates and utensils on the dining table.
- Encourage exercise. Balance his food intake with regular physical activity. Apart from building his appetite, exercise can also strengthen his bones, build his muscles, and improve his heart health.
- Monitoring and consultation. Keep track of your child’s growth (i.e. his height and weight) every 6 months, as well as his developmental milestones. If you have any concerns with his 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. Calorie-dense food such as potatoes, wholegrain cereals, eggs and nuts can also be included to meet the growth demands of the child.
Undernutrition: a cause for concern
Underweight can contribute to mortality risk in children, especially when they are severely underweight. Wasting, on the other hand, can lead to poor functioning of the immune system; therefore children may be 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.
Steady but continuous growth in your 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 his 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.
An educational collaboration with Nutrition Society of Malaysia.