When Your Child Is Not Growing Well

A child’s height should be between the 3rd percentile to the 97th percentile of the WHO growth chart – anywhere below the 3rd percentile is considered as short.

When it comes to children’s growth, it is a general perception that each child grows at his own pace and time.

What most people do not realise is that stunted growth is a major issue that affects a large proportion of the Malaysian population. In fact, it has been found that 2 out of 10 Malaysian children below the age of five are stunted. This figure is equivalent to a rate of stunting of about 21.8%. This, according to the 2019 National Health and Morbidity Survey (NHMS), was three times higher than the overall 7% prevalence in upper middle-income countries.

Under the National Plan of Action for Nutrition of Malaysia 2016 to 2025, the 21% stunting rate in Malaysia exceeded the 11% target set for 2025.

This phenomenon affects all income levels and ethnic groups, and is equally present in both cities and villages.

When a child seems to be rather short compared to his peers, many parents assume that the child is a late bloomer, or attribute it to genetics (parents’ height).

However, it is important that parents should not make such an assumption as abnormal growth in children could potentially affect the child as he matures into an adult later.

Child growth is measured by the height chart set by the World Health Organisation (WHO), which is generally accepted as the worldwide standard. Healthy normal growth in children is considered as falling above the third percentile of the chart – anything below that is considered slow.

There are separate charts available for boys and girls.There are separate charts available for boys and girls.

Prof Dr Yazid advises parents to measure their child’s height at least once every three to six months to observe their child’s growth patternProf Dr Yazid advises parents to measure their child’s height at least once every three to six months to observe their child’s growth pattern

One major factor in abnormal child growth is hormonal issues.

Growth hormone, in particular, plays an important part in child growth especially after the age of five.

As this hormone affects the development and growth at the growth plate, a lack of it in a child’s body would have adverse effects on height, resulting in him being of shorter stature than his peers.

According to University Malaya Medical Centre (UMMC) Department of Paediatrics head and senior consultant paediatric endocrinologist Prof Dr Muhammad Yazid Jalaludin, this highlights the importance of monitoring a child’s growth rate by regularly taking height measurements.

Prof Dr Yazid advises parents to measure their child’s height at least once every three to six months so that they can observe their child’s growth pattern.

“It is important to keep track of a child’s height regularly to ensure he has not fallen off the growth chart, ” he said.

“It is also a good indicator that something is wrong if the child is not exhibiting healthy growth, so immediate remedial action can be taken after determining the cause.”

“The importance of regular measurement of a child’s height is often overlooked, which means by the time a growth issue is suspected or identified, it is often too late to do much about it.”

“When a child has reached puberty, the window for growth is fast closing. Therefore, it is important to address any growth issues before puberty hits.”

It It is important to keep track of a child’s height regularly.It It is important to keep track of a child’s height regularly.

Growth hormone issues, if left untreated, can potentially lead to health problems later in life.

For one, growth hormone deficiency can increase deposits of fat tissue around the abdomen and facial area, which can lead to obesity and heart problems in the long run.

Also, growth hormone deficiency can affect muscle development.


Growth hormone deficiency can be treated by injecting synthetic human growth hormones into the fatty tissue that lies under the skin.

These days, it is a simple procedure that can be done at home using an injection pen or device that administers measured doses.

This treatment could only be initiated by a paediatric endocrinologist, and is available under the Government’s patient welfare fund, as well as through various NGOs.

“For parents in the lower income bracket, you do not have to feel alone. There are various avenues to reach out for help if your child is diagnosed with growth hormone deficiency. Your doctor would be able to help you explore your financing options, ” said Prof Dr Yazid.

As regular measurement of your child’s growth is important, there is now a mobile app to help parents stay on top of this.

Endorsed by the Malaysian Paediatric Association, The Growth Journey mobile app allows parents to chart their child’s growth as well as get serial measurements to ensure growth is on track.

It aims to empower parents with knowledge of their child’s height to monitor their child’s growth, which can prompt them to seek help with healthcare professionals to address any growth issues.

Using this app is simple. Just fill in the details that include basic information, such as a child’s age and parents’ height and snap a picture of your child standing next to an adult. The app then plots your child’s height automatically and compares it with the official WHO child growth standards. This can be conveniently done via your handheld device.

“I strongly urge parents to use this app for early detection of growth issues. It is available for free, and you can address any issue that arises early to ensure optimum care is given to help your child grow healthily, ” said Prof Dr Yazid.

In addition to balanced growth hormone levels and proper nutrition, he also advises parents to ensure that their children get enough quality sleep – ideally going to bed before 10pm, as well as daily physical activities for optimum growth.

The Growth Journey mobile app comes with camera functionality to help you track your child’s growth. The app does not offer personalised medical diagnosis or patient-specific advice. The content and features in this app are for information purposes only. Should your child have a medical condition, consult your doctor or health care provider. Download the app free from Google Play or Apple App Store.

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