Growth retardation in children, what should be done to compensate?

Growth retardation refers to height below the standard reference value for normal height for the same age and gender, reflecting a long-term dietary nutritional imbalance and a type of malnutrition. According to surveys, the growth retardation rate in China is 4.8% for children under 6 years old and 1.7% for children and adolescents aged 6-17 years old.Growth retardation not only affects the physical and intellectual development of children and adolescents, but may also lead to short stature in adulthood and increase the risk of chronic diseases such as obesity, cardiovascular diseases and diabetes, which is one of the major public health problems facing China today.

How can I tell if my child has growth retardation?

Growth retardation is a chronic malnutrition that is caused by inadequate dietary intake of protein or energy, vitamins and minerals, resulting in height below the age-specific height cut-offs for screening.

Determination of growth retardation in children and adolescents of different ages.

What can be done to help children with growth retardation?

When children experience growth retardation, the following 6 principles and recommendations can be followed for daily food nutrition.

1. Variety of food to meet growth and development needs.

Children’s meals should include 3 or more of cereals and potatoes, vegetables and fruits, livestock, poultry, fish and eggs, milk and soybeans at each meal; the food variety should be >12 types/day; >25 types/week.

Children aged 2-5 years achieve 3 main meals and 2 extra meals per day; choose nutrient-dense foods or extra meals such as milk, fruit, eggs and nuts with a small amount of fluffy pastry; drink 350-500ml of milk and 600-800ml of water per day.

Children and adolescents aged 6-17 years should arrange their three meals wisely and eat a good breakfast; they should consume more than 300ml of liquid milk or an equivalent amount of dairy products every day.

The recommended intake of various types of food for children and adolescents in different age groups is shown in the chart below.

2. Eat according to the individual and the time of day to regulate the spleen and stomach.

Food selection and consumption should be adapted to the time and place, and appropriate food should be chosen according to the characteristics of the geographical environment, eating habits and food availability of each place.

In spring, when the cold is gradually receding and Yang Qi is developing, you should take in appropriate pungent and warm things to help the development of Yang Qi, such as onions, garlic and leeks.

In summer, yang energy crosses out and yang energy in the body is deficient, so you should eat less cold and raw food.

Autumn is dry, choose sweet and moist foods to nourish the lungs, such as snow pear and silver fungus.

Winter is cold; while warming up, you should not forget to nourish yin, so you can eat duck meat, pork, etc.

3. Cook reasonably and develop healthy eating behaviour.

Children’s food should be prepared by steaming, boiling, stewing and simmering, and less by deep-frying, grilling and pickling.

For children aged 2-3 years, food preparation should be appropriately finely chopped and soft, and foods with broken bones, spines, cores and shells are not recommended to avoid eating accidents.

For children aged 2-5 years, it is advisable to prepare food with less seasoning and to change the shape or texture of food, food portions and cooking methods frequently to increase children’s appetite. Children and adolescents aged 6-17 years should refrain from mindless dieting and overeating. Prohibit alcoholic beverages and reduce consumption of foods such as pickles, spicy bars, candies, preserves, margarine cakes, ice cream and fatty meats.

4. Provide nutrition education and create a healthy food environment.

Nutritional knowledge and skills can be imparted to children and adolescents and their parents through various communication channels, such as schools and communities, to gradually improve the nutritional literacy of children and adolescents and their parents.

5. Maintain appropriate physical activity and pay attention to sleep and mental health.

Physical activity.

Children aged 2-5 years should spend a total of 3 hours of physical activity per day, with ≥2 hours of outdoor activity per day, of which ≥1 hour of physical activity of moderate intensity or above should be accumulated.

Children and adolescents aged 6-17 years should engage in ≥1 hour of moderate-to-vigorous physical activity cumulatively per day.

For children and adolescents with growth retardation, there should also be 3 days per week of exercise to strengthen muscle strength and/or bone health (e.g. tug-of-war, long jump, etc.)

Sleep.

Children aged 2-5 years should have 10-13 hours of sleep per day, including 1-2 hours for naps.

Children aged 6-12 years should have 9-12 hours of sleep per day.

Children and adolescents aged 13-17 years should have 8-10 hours.

Mental health.Emphasis on emotional and behavioural management of children and adolescents, guidance on proper body image, maintaining a healthy weight and promoting healthy physical and mental development. Pay attention to behaviours that endanger physical health such as emotional under-eating and restrictive eating, and improve growth retardation in children and adolescents by combining psychological and emotional interventions such as psychological guidance and communication with a rational diet.

6. Regularly monitor physical development and strengthen dietary assessment and guidance.

Based on their gender, age and nutritional status, children and adolescents should be dynamically and longitudinally followed for at least six months (preferably 12 months) to assess their growth status according to their growth rate or deviation from the growth curve, and adjust the guidance programme in a timely manner.