Growing up Milk for Southeast Asian Children

4 min read /

 

Chai Pei Fan, MBBS, MRCPCH (UK), AM (Malaysia)

 

  • Consultant Pediatrician
  • Pediatric Gastroenterologist & Hepatologist. Pentai Hospital Kuala Lumpur, Malaysia


Early childhood nutrition is important to ensure optimal growth and development and has long-lasting health implications that persist into adulthood.

While much attention has been given tot he issue of childhood obesity, the problem of undernutrition still exists in a large part of Asia's child population.1,2

Compared with other Asian sub-regions, Southeast Asia has the second highest prevalence of stunting (27.4%), wasting (9.4%) and underweight (18.3%) in children under the age of 5 years.

These figures are greater than the prevalence of children who are overweight (6.1%). Approximately 45% of all child deaths (or 3.1 million deaths annually) are related to childhood undernutrition.1

Macronutrient and micronutrient deficiencies are most likely to occur during the early years of life, when rapid growth and development occurs.3

Not all children receive exclusive breastfeeding through the first 6 months nor continue to breastfed for up to 2 years as recommended by the World Health Organization.4

While locally-prepared foods are encouraged during complementary feeding, most family diets do not provide the recommended macro- and micronutrients required during this period of rapid growth. Common issues that young children face like picky eating, high intake of unhealthy snacks, infrequent meal patterns and lack of food diversity further increase the risk for malnutrition.5,6

Socioeconomic differences and disparity in food availability between countries and within the country also contribute to inequalities in childhood nutrition.6

Macronutrient and micronutrient defiencies of particular concern in Southeast Asian children include the lack of protein energy, iron, iodine, calcium, folate, zinc, and vitamins, A, D, B12 and C, as well as essential fatty acids.1,2

Growing Up Milk (GUM) for children ages 1 year and above, is a simple but effective means for addressing these dietary gaps.7

If can be considered an affordable source of nutritional supplement to meet the need of growing children.

Compared with regular cow's milk, GUM has:
- a lower protein content 
- a higher concentration of essential fatty acids
- fortified with micronutrients that is otherwise low or absent in regular cow's milk.3

The recommended number of daily servings is 1 to 2 cups or an average of 300 ml/day. This should comprise 15% of the total energy intake for young children aged 1 to 3 years.2

 

 

Summary:

 

 

  • Undernutrition is prevalent among Southeast Asian children and is still a major cause of child morbidity and mortality.
  • GUM plays an important role as a good source nutrient supply in young children to preventing macro- and micronutrient deficiencies among high-risk groups.
  • GUM should be served in appropriate portions in recommended concentrations and frequencies instructions to avoid underfeeding of overfeeding.

 

 


References

 

 

 

  1. Black RE, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427-51.
  2. Suthutvoravut U, et al. Composition of follow-up formula for young children aged 12-36 months: recommendations of an International Group Coordinated by the Nutrition Association of Thailand and the Early Nutrition Academy. Ann Nutr Metab 2015;67:119-32.
  3. Eussen SR, et al. Theoretical impact of replacing whole cow's milk by young-child formula on nutrient intakes of UK young children: results of a simulation study. Ann Nutr Metab 2015;247-56.
  4. Walters D, et al. The cost of not breastfeeding in Southeast Asia. Health Policy Plan 2016;31:1107-16.
  5. Taylor CM, et al. Micro- and macronutrient intakes in picky eaters: a cause for concern? Am J Clin Nutr 2016;104:1647-56.
  6. Chapparo C, et al. Overview of the nutrition situtation in seven countries in Southeast Asia. April 2014.
  7. Hojsak I, et al. Young child formula: a position paper by the ESPGHAN Committee on Nutrition. J PediatrGastroenterol Nutr 2018;66:177-85.
  8. Michaelsen KF, et al. Protein needs early in life and long-term health. Am J Clin Nutr 2014;99(suppl):718S-22S.
  9. Brand-Miller J, et al. Effect of added carbohydrates on glycaemic and insulin responses to children's milk products. Nutrients 2013;5:23-31