Dr Chan (right) and Dr Norazlin are among the experts behind the screening toolkit for parents of children under five years old. — Photos: RAJA FAISAL HISHAN/The Star
EXPERTS agree that the most important period in a person's life is from the moment an infant is born until he or she reaches five years old. That's roughly 1,827 days and once you have missed that window, you can't get it back.
That's why paediatricians strongly encourage parents and caregivers to pay very close attention to infants as they go into toddlerhood and become children. Everything, from complementary feeding and diet to early diagnosis of health conditions and interventions, should start when a child is very young.
Consultant paediatrician Datuk Dr Zulkifli Ismail says from birth to five years old, the brain rapidly grows and the development is at its maximum. "If we miss this opportunity to stimulate and nourish the brain and the body of the child, he or she may not be able to catch up."
"This is also when the greatest increase in brain growth occurs and any deficiency – like iron – or serious illnesses, like malnutrition or other chronic illnesses that are not properly treated, will retard the affected children's growth and prevent both optimal development and intellectual functioning,"
When it comes to children's health and well-being, the statistics don't look too good. The Iron Strong study, carried out by Universiti Malaya Medical Centre (UMMC)'s Clinical Investigation Centre revealed that in 2022, almost half of children under five years old are anaemic. Anaemia's implications go beyond physical growth – it affects cognitive development and immune function.
The National Health and Morbidity Survey 2022 found that one in five children are stunted (short for their age) and one in ten are affected by wasting (too light for their height), Dr Zulkifli says.
"On top of that, the same survey revealed that 7.4% of children below five experienced delays in various developmental aspects."
The numbers, he says, shows that parents face challenges in making sure their children develop optimally, and there is a need to guide them on this.
More information for parents
Dr. Zulkifli, who is also the Positive Parenting management committee chairman, spearheaded the Positive Parenting Malaysia 360° Growth and Development Toolkit, launched recently by Women, Family and Community Development Minister Datuk Seri Nancy Shukri. It was developed with a panel of experts which include developmental paediatricians Dr Rajini Sarvananthan, Dr Cindy Chan Su Huay and Dr Norazlin Kamal Nor and nutritionist Dr Roseline Yap.
The toolkit, he says, is meant as a screening tool to be used by parents to detect early developmental, growth, nutritional and chronic health issues.
"The charts included in the respective topic's pockets will help parents and caregivers map their child’s growth. There are growth charts to help parents detect undernutrition, overnutrition and stunting, a developmental flow chart, vaccination list for shots under the National Immunisation Programme (NIP) and also other additional recommended vaccines. There is also a chapter on proper complementary feeding."
Parents can also access specific sites in the Positive Parenting website by scanning specific QR codes enclosed with the toolkit.
Nancy agrees that to promote healthy child growth and development, collective efforts at various levels including individuals, parents, community, government and the nation as a whole, are needed.
"While child development is influenced by several individuals such as teachers and friends, it is widely acknowledged that parents hold the primary and crucial role in this process. So it is vital to recognise that, without the necessary knowledge and tools, parents may unintentionally hinder their child's ability to reach his or her full potential,"
She also urges all healthcare professionals, parents and stakeholders to support this self-screening and reference tool by spreading the word, so "we can reach out and touch the lives of more parents in assisting them on their parenting journey."
Nancy (centre) with Dr Zulkifli (left) and Malaysian Paediatric Association president Dr Selva Kumar Sivapunniam at the launch of the Positive Parenting Malaysia 360° Growth and Development Toolkit.
Bringing up a child
Dr Chan says the toolkit comes at the right time, given the overwhelming amount of information (and misinformation) that parents may find online.
"Parents may be overloaded with information, and this toolkit gives you the key areas that you need to go through first. It empowers parents with the knowledge they need – presented in a simple, easy-to-understand format – so they know what to do," she says.
Dr. Zulkifli says raising healthy children starts with educating parents and would-be parents on proper balanced nutrition, among others.
"Complementary feeding is the introduction to solid food and what we feed children at the beginning of this journey will determine what they eat in later life. Early introduction to sweet foods, for example, will lead to a propensity to take more sugar and sweets, increasing weight and the risk of developing diabetes."
"Childhood is a crucial and an influential stage to establish healthy habits for life, so parents need to facilitate this stage by providing the child with the right nutrition and to instil healthy eating habits."
He says the toolkit's developmental chart allows parents to single out red flags and to get their child examined by a paediatrician.
"Red flags will lead us to investigate deeper and establish a diagnosis and formulate appropriate therapy or treatment. It is the initial screening and it's very important because detecting these symptoms early will result in early therapy or intervention. Some developmental conditions may not do well if therapy is started late," he says.
The 360° Growth and Development Toolkit will be distributed nationwide and can be redeemed for free at participating clinics. Parents can also request for one from www.mypositiveparenting.org (postage and handling charges apply).
