Full nutrition but still short?

This is an automatically translated article.

Posted by Master, Doctor Nguyen Thanh Hung - Department of Pediatrics - Neonatology - Vinmec Nha Trang International General Hospital
Although many parents today do not consider weight as a determining factor in a child's development. However, if the child eats a lot, is well-nourished, but still short, it is also a problem for parents to worry and find out why.

The first thing, parents need to know the factors that affect the height of their children, followed by the important milestones that have the most impact on the growth in height:
Factors affecting height The height of the child was shown, including: Genetic factors according to parents' height, good nutritional diet for each stage, adequate sleep according to age, physical and sports activities, gender as well as a other chronic and endocrine diseases. Important milestones that parents need to pay attention to, because this period has the most impact on children's height growth: Fetal stage, first 3 years of life and pre-puberty stage. In which the first 3 years of life is the most important period. Specifically:

1. Fetal stage

During pregnancy, the mother needs to be provided with four essential nutritional groups, including:
Flour, sugar (Carbohydrates); Protein (Protein): Lean meat, poultry, fish, eggs, vegetable protein including beans and seeds; Fat (Lipid); Vitamins, fiber and minerals: Pregnant women need to pay attention to supplement with Folic Acid, Calcium, Vitamin D and Iron. Pregnant mothers need to avoid stress as much as possible, add enough water, get enough sleep, besides, parents can interact with the fetus through music, reading stories...
Gentle exercise activities, avoiding pregnancy trauma or sudden movements, walking is a good choice at this stage.
In addition, pregnant women also need to have regular antenatal checkups, perform prenatal screenings and get advice from an obstetrician.

2. The first 3 years of life

Before 1 year of age, milk is still the main source of nutrition to help babies grow and develop. If parents reduce the amount of milk each day and replace it with solid foods, the baby's body may not adapt, so the child will not be able to develop well, this mistake often occurs when parents see that the child is drinking less milk. (Physiological - Wonder weeks), so there will be a mentality to give the child complementary food. Currently, there is no recommendation on the best method of weaning, so parents can consider choosing according to the habits and conditions of each family. It should be noted that the method of infant feeding has a high risk of causing foreign body choking in children under 07 months of age.
It is necessary to train children to distinguish day / night from right after birth, so that it can be easier for them to fall asleep. Getting enough sleep, sleeping through the night is proven to have a good effect on height growth. The recommended sleep time for children according to WHO recommendations is 14-17 hours for babies under 3 months and 12-16 hours for children 4-11 months including naps. At this stage, children need to supplement with 400 units of Vitamin D per day, vitamin D deficiency also has a secondary effect on malabsorption, as well as immunity. In addition, vitamin K supplementation is also very important. Vitamin K and Vitamin D work together, supporting each other in calcium metabolism. Vitamin K is found in green vegetables, fermented foods, and egg yolks. A nutritionally complete diet is still at risk of vitamin K deficiency if children have multiple courses of antibiotics or prolonged antibiotic use... Depending on the stage of weaning, parents can choose appropriate foods. Children can participate in outdoor activities early, if the space is fresh and clean. Especially when the child can crawl, sit or hold on to at least 30 minutes a day, avoid letting the child stay in one place for longer than 1 hour such as a stroller, dining chair... . Children can participate in games to develop their senses, play with balls, learn to walk... When the nutrition is adequate, children still slow to grow in height (the first year the child increases by 20-25 cm. , 10-12 cm increase in the first 3 months), need to see a doctor for examination and advice to find other causes: Like milk protein allergy, gastroesophageal reflux disease, chronic digestive diseases, disorders metabolism...

1-3 years old:
Different from the period before the age of 1, this stage is a comprehensive nutrition for children, but still maintaining milk supplementation, it is easier to choose milk for children besides breast milk compared with the previous period. Children need to eat a varied and nutritious diet with protein, fat, starch, vitamins, fiber and minerals. Attention should be paid to foods rich in calcium, iron, zinc... Children should still be provided with oral vitamin D at a dose of 600 units/day. From 1-2 years old, the child's height can increase by an average of 12 cm and from 2-3 years old it is 9 cm. Maintain sleep, can try with useful activities to create circadian rhythms such as reading stories to children every night before going to sleep. Average sleep time is 11-14 hours per day including naps. Outdoor physical activities are very necessary at this stage, at least 180 minutes a day, so children should be involved with motor games. Parents can engage their children with moving games on the sand, lawn or water environment with the help and supervision of parents, to develop skills and senses. From this stage, children also need periodic deworming. From the 4th year onwards, the child's height increases by 5-6cm per year.
If the above activities, parents have done well, but the child's height is still not up to the standard. Parents can take their children to reputable facilities, so that the children can be examined, consulted and additionally tested to find other causes (if necessary).

3. Children with food allergies

Puberty in girls averages 10-16 years old, boys 12-18 years old. In the period of pre-puberty and puberty, children's height increases markedly, with a period of 1-2 years, the height of children reaches 8-12cm per year if well cared for. But when entering puberty, the child's height will level off, increasing to an average of 1-2 cm per year.
So, at this stage, in addition to the full nutrition as mentioned, children still need to continue to be supplemented with milk 500-600ml/day. Children eating 3 main meals with breakfast is important to help provide enough energy for children to study and be active, absolutely do not skip meals. Children can be supplemented with 2 extra meals. Foods rich in calcium are milk, shellfish, small fish with bones, eggs. Besides, iron is an important component in hematopoiesis, the lack of iron slows growth, affects learning and thinking, iron-rich foods are found in animal liver, red meat, fish, and amaranth. . Zinc is abundant in clams, snails, mussels... Iodine salt also plays an important role.
Observe children to avoid the situation that children go to bed late, sleep time is not enough, because at this age children are easily affected by social networks, online games... The average sleep time per day is 10 -11 hours for children 7-12 years old, 8-9 hours for children over 12 years old.
Exercising at this stage is very important (at least 60 minutes per day), it not only helps children grow in height, but also enhances physical strength, endurance as well as responsiveness. immunity. Depending on space, family conditions, school and child's gender, children can participate in sports such as swimming, basketball, jogging...
Another pretty important note is that parents need to keep an eye on them. to detect early signs of puberty in children, before the age of 8 for girls and before the age of 9 for boys, so that children can be examined with pediatric endocrinologists.

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Note: This article is part of the Vinmec International General Hospital System's Awareness Program on Growth Retardation, with the support of Novo Nordisk
References: who.int, cdc.gov