Food aid alone may not prevent child malnutrition from returning, says dietitian
PETALING JAYA: For a child recovering from malnutrition, six months of food assistance may improve their nutrition, but those gains may not last once the aid ends.
A clinical dietitian has warned that the real test begins when food baskets and fresh produce stop arriving. Continued monitoring, caregiver support and access to affordable, nutritious food are needed to prevent children from slipping back into malnutrition.
READ MORE: KL child malnutrition rates ‘worrying’, says Health Minister
UM Specialist Centre clinical dietitian Rozanna M Rosly said food assistance could improve food availability in vulnerable households, but should be treated as an intervention rather than the endpoint of a child’s nutritional care.
“The critical question is: what happens in month seven?”
Rozanna said children should be assessed after six months to determine whether their growth, diet and feeding practices had improved, with continued monitoring for those who remained nutritionally vulnerable.
“Food baskets can address an immediate nutritional need, but sustainable improvement requires us to understand and address why that particular child became malnourished in the first place,” she said.
Food insecurity, affordability, feeding difficulties and illness could all contribute to malnutrition, meaning food aid alone could not meet every child’s nutritional needs.
She added that parents should not bear sole responsibility, as childcare arrangements, schools, peers and food availability also influenced children’s diets.
Long-term prevention, she said, required nutrition support, caregiver education, healthcare and affordable access to nutritious food. Her warning comes amid concerns over child malnutrition in Kuala Lumpur.
Health Minister Datuk Seri Dr Dzulkefly Ahmad previously said National Health and Morbidity Survey data showed that 23.4% of children in Kuala Lumpur were stunted, 12.4% were underweight, 8.1% were wasted and 7.5% were overweight.
“These figures are more than just statistics. Behind every percentage is a child going through a critical stage of development and a family hoping for the support they need,” he said.
Dzulkefly added that Malaysia faced a double burden of malnutrition, with undernutrition existing alongside overnutrition.
The Health Ministry’s Urban Community Feeding Programme, introduced as a pilot in 2013, provides affected children aged one to six with six months of structured support.
This includes monthly growth monitoring, nutritious food baskets and fresh fruit and vegetables every two weeks.
Rozanna said children in this age group were particularly vulnerable to inadequate iron, calcium and vitamin D intake because their diets lacked variety.
Some drank too much milk, grazed throughout the day, frequently consumed sweetened drinks or snacks, or ate a limited range of foods. She stressed that nutrition depended not only on what children ate, but also how they ate.
“Healthy eating for children does not have to be expensive. Eggs, tofu, tempeh, dhal, local fish, seasonal vegetables and local fruits can all provide excellent nutrition. What matters is variety, balance and consistency,” she said.
For breakfast, she suggested oats, bread or another cereal with an egg and fruit or a simple local rice or noodle dish, containing a protein source.
Lunch and dinner could comprise rice, noodles or another staple, paired with vegetables and affordable protein such as eggs, mackerel, other local fish, chicken, tofu, tempeh or dhal.
Local and seasonal fruits, including bananas, papaya, watermelon and guava, could provide greater dietary variety.
For snacks, she recommended fruit, milk, bread, corn and potatoes instead of relying mainly on highly processed foods.
Milk and dairy products could provide protein, calcium and other nutrients, but should complement solid meals rather than routinely replace them.
Rozanna said young children needed a combination of energy, protein and micronutrients, including calcium, vitamin D, iron and vitamin C.
For parents, however, encouraging varied diets can remain a challenge beyond early childhood.
Charlotte Lim, 35, a business owner and mother of a 10-year-old boy, said getting her son to eat home-cooked food was one of her biggest daily struggles.
While she did not consider him an extremely picky eater, he had clear preferences and would immediately reject certain vegetables and dishes.
“He also doesn’t really like certain types of fish, especially sardines or fish with a lot of bones. So, sometimes it can be quite difficult to get him to eat a proper, balanced meal.”
Lim said her son preferred fast food and often resisted homecooked meals.
“Sometimes, to him, homecooked food is like poison!” she said.
She added that although she encouraged him to eat nutritious meals, she worried about how much influence she would have over his food choices as he grew older.
Balancing work, his preferences and nutritious meals remained a daily challenge.
“I can’t always prepare a separate meal just because he doesn’t want to eat what everyone else is eating,” she said, adding that she continued introducing different foods and vegetables.
Rozanna said the success of food assistance should be measured not simply by whether food reached a household, but by whether children’s nutrition improved and families could sustain those gains.
She added that Malaysia needed to look beyond short-term aid and ensure families could continue providing affordable, nutritious diets long after the six-month programme ended.
