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Childhood Obesity in Malaysia: A Growing Concern

Childhood obesity has emerged as a pressing health issue in Malaysia, signaling the need for urgent attention and intervention. This article delves into the prevalence, demographics, and factors influencing the alarming rise of childhood obesity in the country.

Prevalence:

Malaysia, like many other countries, has seen a significant increase in childhood obesity in recent years. The prevalence of childhood obesity in Malaysia has more than tripled over the past two decades. According to the National Health and Morbidity Survey (NHMS) 2019, approximately 20% of children aged 5 to 17 in Malaysia are overweight or obese. This statistic is particularly concerning, as it points to a rising trend that threatens the well-being of the nation's future generation.

Demographics:

Childhood obesity in Malaysia affects various demographic groups, but it is more pronounced in urban areas. Urbanization has brought about lifestyle changes, including a shift towards more sedentary activities and a higher consumption of processed foods, which contribute to weight gain and obesity. Additionally, the prevalence of childhood obesity tends to be higher among boys than girls, with a notable increase in obesity among children of Indian ethnicity.

Factors Influencing Childhood Obesity:

Dietary Habits: One of the primary drivers of childhood obesity in Malaysia is an unhealthy diet. The increased availability of fast food and sugary beverages has led to excessive calorie consumption. Traditional diets that were once rich in fruits, vegetables, and whole grains have been replaced by processed and high-calorie foods.
Lack of Physical Activity: Sedentary behavior, particularly among school-going children, has become a concerning trend. The use of electronic devices, coupled with limited access to safe and active play spaces, has led to a decrease in physical activity.
Socioeconomic Factors: Socioeconomic disparities also play a role in childhood obesity. Families with lower incomes may have limited access to nutritious foods, making them more reliant on cheaper, calorie-dense options.
Parental Influence: Parents' dietary choices and lifestyle habits significantly impact their children's health. Parents who model healthy behaviors, such as regular exercise and balanced eating, are more likely to have children who adopt similar practices.
Marketing and Advertising: The aggressive marketing of unhealthy foods and sugary beverages, often targeted at children, further exacerbates the issue. Eye-catching advertisements can lure children into consuming calorie-laden, low-nutrient products.

Addressing Childhood Obesity:

Efforts to combat childhood obesity in Malaysia must be multifaceted and include:

Education: Raising awareness among parents, caregivers, and children about the importance of a balanced diet and physical activity is crucial. Schools can play a significant role in promoting healthy lifestyles.
Policy Changes: Implementing policies that restrict the marketing of unhealthy foods to children and promote the availability of nutritious options in schools and public spaces is essential.
Physical Activity Promotion: Encouraging children to engage in regular physical activity through school programs and community initiatives can help combat sedentary lifestyles.
Support for Low-Income Families: Programs that provide financial support and incentives for low-income families to access healthier foods can mitigate socioeconomic disparities.
Healthcare Interventions: Healthcare providers should actively monitor and provide guidance to overweight and obese children and their families.

In conclusion, childhood obesity in Malaysia is a critical issue that demands immediate attention. The prevalence is on the rise, impacting various demographic groups. A combination of factors, including dietary habits, sedentary behavior, and socioeconomic disparities, contributes to this epidemic. Addressing childhood obesity requires collaborative efforts from policymakers, healthcare providers, educators, and parents to ensure the well-being of Malaysia's future generations. Only by working together can the nation hope to reverse the alarming trend of childhood obesity and promote a healthier, more prosperous future.

References

New Straits Times. When big is not better. https://www.nst.com.my/lifestyle/heal/2022/04/786913/when-big-not-better
Code Blue. Malaysian Children Heavier than Asea Neighbours, Expert Says. https://codeblue.galencentre.org/2019/09/18/malaysian-children-heavier-than-asean-neighbours-expert-says/
Sidik SM, Ahmad R. Childhood obesity: contributing factors, consequences and intervention. Malays J Nutr. 2004 Mar;10(1):13-22. Epub 2004 Mar 15. PMID: 22691744.

Children and Immunization

Immunization, a critical facet of pediatric healthcare, involves the administration of vaccines to children to bolster their immune systems against various infectious diseases. These vaccines typically consist of weakened or inactivated viruses, as well as whole or partial bacterial components. They are commonly administered via injection, either into the muscle or beneath the skin, or orally. The primary goal of immunization is to safeguard both the individual and the broader community from disease outbreaks. It's important to note that side effects resulting from vaccinations are infrequent and, when they do occur, tend to be mild in nature.

Vaccines consist of antigens derived from either virus or bacteria, in whole or part, and are rendered nonfunctional or weakened. The primary purpose of these vaccines is to stimulate the immune system's response, ultimately establishing protective immunity against specific diseases. Today, many vaccines are available in combination formulations, simplifying the administration process. These combination vaccines amalgamate multiple vaccines into a single injection, offering children protection against numerous diseases in a single dose, thereby rendering the process less painful and more convenient.

In Malaysia, the National Immunization Program (NIP) was introduced in the early 1950s, taking its cues from the World Health Organization's (WHO) Expanded Immunization Program (EPI). The WHO EPI recommends that all countries immunize against six childhood diseases, but in Malaysia, the NIP has expanded protection to cover 13 major childhood diseases.

The 13 preventable diseases under the Malaysia National Immunization Program are as follows:

Diphtheria: An infectious disease caused by bacteria that reside in the mouth and throat of the infected individual.
Haemophilus Influenza type B (Hib): A severe infection that predominantly affects children under the age of 5.
Hepatitis B: An infection of the liver caused by the Hepatitis B virus.
Human Papillomavirus (HPV): The most common sexually transmitted infection (STI) that can lead to cervical cancer, the third most prevalent cancer in women.
Japanese Encephalitis (JE): A viral infection that affects the brain, caused by the JE virus.
Measles: A highly contagious viral disease.
Mumps: A viral infection that is the primary cause of encephalitis or brain inflammation.
Pertussis (Whooping Cough): Highly contagious and characterized by violent, persistent coughing that can lead to breathing difficulties and cyanosis (turning blue).
Poliomyelitis (Polio): An infectious and incurable viral disease that attacks the nervous system.
Rubella: Also known as German measles, it can cause fetal abnormalities.
Tetanus: Also known as lockjaw, caused by bacterial toxins that affect the nervous system.
Tuberculosis (TB): A disease that primarily affects the lungs but can also impact other body parts such as the kidneys, spine, skin, intestines, and brain.
Pneumococcal: A bacterial infection caused by Streptococcus pneumonia that can affect the lungs and other parts of the body.

The importance of these vaccinations remains paramount in today's advanced healthcare landscape. While healthcare systems and technologies continue to advance, several factors necessitate childhood immunization:

Underdeveloped Immune Systems: Infants and children have immune systems that are not yet fully developed. Vaccinations play a pivotal role in training and strengthening a child's immune system, thereby protecting them from potentially life-threatening complications.
Maternal Immunity Is Insufficient: Although newborns may receive some immunity, in the form of antibodies, from their mothers during the last weeks of pregnancy and through breast milk, this maternal immunity is limited in scope and duration. It only protects infants from diseases to which the mother is immune, lasting approximately nine months. Once this maternal immunity wanes, infants become susceptible to various diseases.
Risks of Natural Infection: Relying on natural infection to develop immunity can be perilous. Children's bodies may not always effectively combat these diseases, leading to the necessity of experiencing and recovering from the disease, which in turn puts them at risk of life-threatening complications. Childhood immunization provides a safe and effective alternative, offering protection comparable to that of natural immunity without subjecting children to such risks.

In conclusion, childhood immunization serves as a cornerstone of public health and child well-being. It safeguards children against a wide array of diseases, ensuring their health and contributing to community-wide disease control. The rationale behind immunization, even in a modern healthcare landscape, remains robust, considering the imperfections and limitations of natural immunity and the imperative of bolstering the still-developing immune systems of infants and children. By adhering to comprehensive vaccination programs, we can protect the most vulnerable members of society, securing a healthier future for all.

References

Immunise for life. The Importance of Childhood Immunization. https://immunise4life.my/the-importance-of-childhood-immunisation/
Immunise of life. Malaysia National Immunization Program. https://immunise4life.my/the-malaysian-national-immunisation-programme-nip/
Ministry of Health Malaysia (MOH). MyHealth Portal. Immunization: Facts and Myths http://www.myhealth.gov.my/en/immunisation-facts-myths/
Ministry of Health Malaysia (MOH). My Health Portal. Introduction to Immunization. http://www.myhealth.gov.my/en/introduction-of-immunisation-2/

Caring for a Sick Child and When to Seek Medical Help

Childhood illnesses are an inevitable part of growing up, and it's no surprise that little ones frequently fall ill, given their developing immune systems. This is especially common among children in daycare or preschool environments. While illness can bolster their immune defenses, it can also be a cause of concern for working parents who grapple with the challenge of tending to their unwell children while juggling professional responsibilities.

In this article, we offer valuable tips to aid parents and guardians in providing comfort and care to their sick kids at home.

Listen to Your Child: The first and foremost step when your child falls ill is to lend them your ears. Pay close attention to their complaints, pinpointing any specific discomfort or pain areas. Keeping a record of their symptoms will prove invaluable when discussing the situation with a doctor.

Ensure Adequate Ventilation: Maintain proper air circulation in the room where your child is resting. Fresh air can make them feel more at ease and can help improve their overall well-being.

Warm Baths for Comfort: A warm bath can work wonders in soothing your sick child. It helps alleviate aches and pains, while the steam from the warm water aids in clearing congestion.

Cooling Down with Tepid Sponges: If your child has a fever, use tepid sponges to help lower their body temperature.

Comfortable Clothing: Dress your child in soft, comfortable clothes to keep them cozy.

Stay Hydrated: Offer your child plenty to drink, even if they're not up for eating, especially during the initial stages of illness. Nutrient-rich drinks like milk can help provide necessary sustenance.

Engage with Them: Once your child is ready, engage them with quiet games, stories, or simply your company for comfort and companionship.

Prioritize Rest: Illness can be exhausting, and your child needs plenty of rest. Encourage them to nap as needed, perhaps with a soothing bedtime story.

So, when should you consult a doctor? The signs and symptoms vary based on your child's age. For instance, if your child is less than two months old and has a fever with a temperature exceeding 37.5 degrees Celsius, it's crucial to seek medical attention immediately. For older children, the primary concern is ensuring they stay hydrated. If they can't tolerate food or drinks and are experiencing issues like vomiting, diarrhea, or difficulty swallowing, consult a doctor promptly.

Look out for signs of dehydration, which can include fewer wet diapers (less than six per day in infants), dark urine, dry diapers, dry, cracked lips, sunken eyes, crankiness, and a sunken soft spot on the top of the head in babies younger than 18 months.

In summary, caring for a sick child requires a delicate balance of attention, comfort, and medical vigilance. By following these tips and recognizing when to seek professional help, you can ensure your child's well-being during their journey to recovery.

References

National Health Service (NHS) (UK). Looking after a sick child (Nov 2021). https://www.nhs.uk/conditions/baby/health/looking-after-a-sick-child/
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Fever in children: Overview. 2013 Dec 18 [Updated 2019 Jun 6]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279455/

Benefits of EPA and DHA for children

EPA and DHA are a type of Omega 3 (essential fatty acids). One of its most important benefits is to give the anti – inflammatory effect to the body. A lot of diseases, like heart diseases, and arthritis, seem to be related to an inflammatory process, therefore EPA and DHA are important as they help body to turn down the inflammation hence prevent some of these chronic diseases.

As for children, studies on infants, prenatal health, and pregnancy, found out that it can help with:

Cognitive function

Brain grows at the greatest rate from birth until about 2 years old of life. Over 60% of the brain is made up of fat, 10 – 15% of it is from DHA. It is necessary for the development of sensory, perceptual, cognitive, and nerve system.

Study that was conducted on cognitive function and EPA and DHA consumption shows that children born to a mother who consumed DHA and EPA during pregnancy have higher score on cognitive test at 4 years old as compared to children whose mothers did not consume EPA and DHA supplement during pregnancy and breastfeeding.

ADHD

Attention -deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Study have shown that children with ADHD have lower levels of EPA and DHA when compared to those without ADHD, a few small studies look at the consumption of fish oil supplement as treatment, and found out that the supplements might improve behavior, reduces hyperactivity, and boost attention in children below 12 years old.

Another article reviewed a range of studies carried out between 2000 – 2015 found out that the result of consuming EPA and DHA to the benefits of ADHD are somewhat inconsistent. However, an article published on 2019 concluded that combined doses of EPA and DHA equal to or above 750 mg per day for more than 12 weeks have shown improvements on symptoms of ADHD.

Growth

There is evidence that when EPA and DHA are added to formula milk, it promotes growth and brain development in premature infants. However, breast milk is the ideal milk for baby, it is also a great source of EPA and DHA, although it varied depending on mothers’ diet it still is the best milk for children.

References

Nutriadvance. Top 10 Reasons to Give Your Kids Omega 3. https://www.nutriadvanced.co.uk/news/top-10-reasons-to-give-your-kids-omega-3/ (Retrieved on Sept 28, 2022).
WebMD. Nourish by WebMD. Who Needs Omega 3s? https://www.webmd.com/diet/features/who-needs-omega-3s (Retrieved on Sept 28, 2022).

EPA and DHA for children

EPA and DHA are a type of Omega 3 or fatty acid that play a vital role for various health functions such as brain function, heart health, and immunity.

EPA and DHA are converted from Alpha – Linolic Acid (ALA) in the body. ALA can be found in variety of plant-based foods, such as vegetables oils, nuts, and seeds. However, the conversion of ALA to EPA and DHA is in a very small amount.

Other than from the ALA source, EPA and DHA are widely available in supplements, and naturally found in fatty fish such as mackerel, tuna, and salmon.

During the first year of life, babies get their EPA and DHA from either breast milk or fortified formula.

As for toddler and young children, different age and gender requires different amount of EPA and DHA as per follows:

0 to 12 months: 0.5 grams/day

1 to 3 years: 0.7 grams/day

4 to 8 years: 0.9 grams/day

9 to 13 years (boys): 1.2 grams/day

9 to 13 years (girls): 1.0 grams/day

14 to 18 years (boys): 1.6 grams/day

14 to 18 years (girls): 1.1 grams/day

It is extremely important to get the required amount of EPA and DHA during critical period of children’s rapid growth as it can help with brain development, cognitive function, and eye development.

There are also studies indicates that EPA and DHA may improve symptoms of ADHD, reduces asthma, promotes better sleep, and enhances brain health.

In conclusion, apart from ensuring children’s diet is balanced and variety, it is also best to top up their nutrient intake upon recommendation from healthcare professional. Talk to your healthcare professional whether your child require supplementation etc.

Navigating Kids' Nutrition: To Supplement or Not to Supplement?

In today's world, we often encounter children who are either a bit too thin or slightly overweight. Numerous factors contribute to this issue, prompting health authorities to initiate nutrition programs in schools, involving food caterers, parents, and teachers. These initiatives even extend to banning junk and processed foods from both inside and outside school premises.

The gravity of childhood malnourishment, whether in the form of obesity or undernourishment, cannot be overstated. Long-term obesity or underweight conditions in childhood can lead to severe health complications in adulthood, including diabetes, hypertension, heart problems, kidney issues, and more (2).

FACT CHECK!

According to the World Health Organization (WHO), malnutrition encompasses deficiencies, excesses, or imbalances in a person's energy and nutrient intake. It includes undernutrition (stunting, wasting, underweight, and micronutrient deficiencies) and overweight, obesity, and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes, and cancer).

Despite numerous efforts, combating childhood malnourishment remains challenging. This problem is further compounded by children who frequently fall ill due to insufficient vitamin and mineral intake.

The American Pediatric Association suggests that not all children require supplements, but specific groups do benefit from them, including children who:

Follow a vegetarian or vegan diet.
Have conditions that affect nutrient absorption or increase nutrient needs (e.g., celiac disease, cancer, cystic fibrosis, or inflammatory bowel disease).
Have undergone surgeries impacting their intestines or stomach.
Are extremely selective eaters struggling to diversify their diets.

Many children today are picky eaters, making it difficult for working parents to introduce variety into their meals due to time constraints. Consequently, they often allow their children to eat what they prefer, hindering their growth. These children may benefit from supplements to compensate for the nutrients they miss out on.

Some children also face appetite issues. Nutritionists recommend creative approaches to improve children's appetites:

Engaging in food-related games, such as having them discover hidden vegetables during meals.
Creating visually appealing food presentations, resembling characters from their favorite cartoons.
Involving children in cooking processes, sparking their interest in food.
Introducing diverse foods to prevent mealtime monotony.

However, time constraints remain a significant challenge for working parents. Hence, many turn to multivitamins and mineral supplements as a convenient solution.

However, caution is vital when considering supplements (1, 4, 5, 6):

Children below 2 years old should avoid supplements and instead explore a variety of foods.
Steer clear of megadose supplements, which can be harmful. Consult healthcare professionals for appropriate dosages based on your child's age.
Inform healthcare providers about any medications your child is taking, as some medications and supplements can interact.

In conclusion, supplementation should not serve as a long-term solution for parents. Encouraging children to consume a diverse and healthy diet is paramount. It is advisable to consult pediatricians, doctors, dietitians, or nutritionists regarding your child's dietary preferences before considering any supplements for them.

References

Healthline (n.d). Vitamins for Kids. Do they need them (And which ones)? https://www.healthline.com/nutrition/vitamins-for-kids
Bracale, R., Milani, L., Ferrara, E., Balzaretti, C., Valerio, A., Russo, V., Nisoli, E., & Carruba, M. O. (2013). Childhood obesity, overweight and underweight: a study in primary schools in Milan. Eating and weight disorders : EWD, 18(2), 183–191. https://doi.org/10.1007/s40519-013-0036-9
Children Health System (n.d). Children activities. https://healthykidshealthyfuture.org/5-healthy-goals/nurture-healthy-eaters/classroom-activities/
BBC Good Food (n.d). Recipe for kids. https://www.bbcgoodfood.com/recipes/collection/kids-cooking
WebMD (n.d). Vitamins for kids: Do Healthy Kids need supplement? https://www.webmd.com/parenting/guide/vitamins-for-kids-do-healthy-kids-need-vitamins#1
Mayo Clinic. Healthy Lifestyle. Nutrition and Healthy Eating. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/multivitamins/faq-20058310

Colostrum is beneficial to babies, but does it also benefit adults?

Colostrum is a type of breast milk produced by mammals, including humans. Before breast milk is released, it is usually thicker in consistency and contains high levels of antibodies. This high concentration of nutrients in the colostrum is aimed at promoting the growth and health of newborn mammals, which is why it is the most nutritious form of milk (1).

For humans, the consumption of colostrum by newborns is very much encouraged; apart from the promotion of exclusive breastfeeding up to 6 months and 2 years by the Ministry of Health Malaysia (MOH), mothers are as well encouraged to give skin-to-skin support while breastfeeding newborns for the colostrum few hours after delivery.

The colostrum is said to have various benefits for the newborn as they get older (2).

What about the adults? Does adult consumption of bovine colostrum have the same effect as mother-to-newborn colostrum?

Bovine colostrum is more nutritious than regular milk. It contains more protein, fat, carbohydrates, magnesium, and vitamins A, C, B, and E than regular milk. Due to this, studies have found that the consumption of bovine colostrum by adults is useful in boosting the immune system as well as improving gut health (1, 3).

The presence of lactoferrin in colostrum contributes to the link between colostrum and immunity. Lactoferin is a protein that occurs naturally in the body. It is a very versatile protein because it is a bi-lobed protein that can bind an iron atom (4). This transferrin-family iron-binding glycoprotein is an important component of the mammalian immune system. As a result, it provides lactoferrin with protective effects ranging from direct antimicrobial to anti-inflammatory and anti-cancer (4).

Apart from this, colostrum also contains antibodies. Antibodies are proteins, also known as immunoglobulins, used by the immune system to fight bacteria and viruses. Bovine colostrum is rich in the antibodies IgA, IgG, and IgM (1, 2). This is also essential for fighting pathogens and improving the immune system.

Since bovine colostrum is loaded with nutrients that fight disease and promote growth, it is able to boost immunity, treat infections, and offer more related benefits to humans throughout their lives. Thus, the consumption of bovine colostrum may have the same effect as human colostrum; it is just that the absorption of colostrum from a bovine to a human body is different, but with all the spectacular ingredients that colostrum possesses, it may possess the same effect as boosting immunity!

References

Healthline. What is the colostrum? Nutrition, Benefits and Downsides. https://www.healthline.com/nutrition/bovine-colostrum (Accessed on July 9, 2020).
Bloomlife. Breastfeeding Tips To Know Before the Baby Arrives. https://bloomlife.com/preg-u/breastfeedingtipscolostrum/#:~:text=Studies%20show%20that%20expressing%20colostrum,in%20her%20first%20few%20days (Accessed on July 9, 2020).
WebMD. Bovine Colostrum. https://www.webmd.com/vitamins/ai/ingredientmono-785/bovinecolostrum (Accessed on July 9, 2020).
Bioquad Lifesciences. https://bio-quad.com/blogs/article-1/whatislactoferrin (Accessed on July 9, 2020).

Healthy Children, Happy Parents: Preparing Your Kids for School

As schools reopen, children and parents are gradually returning to their routines, but it's crucial to ensure our children are equipped to maintain their health and well-being. In this article, we'll explore how proper nutrition and practical tips can bolster your children's immune systems and contribute to their overall well-being.

1. Prioritize Basic Protective Measures

Before sending your children to school, instill in them the importance of basic protective measures:

Hand Hygiene: Remind your children to wash their hands thoroughly with soap and water or use an alcohol-based hand sanitizer. However, emphasize that they should wash their hands before eating instead of using sanitizer.
Respiratory Etiquette: Teach your children to cover their mouth and nose with their bent elbow when coughing or sneezing. Encourage them to dispose of used tissues immediately and avoid touching their eyes, nose, and mouth.
Social Distancing: Emphasize the significance of maintaining a safe distance of at least 1 meter from anyone who is coughing or sneezing.

2. Encourage Proper Hydration

Ensure your children stay hydrated throughout the day by:

Providing Water: Encourage your children to bring plain water to school. Water is the healthiest choice and helps maintain their overall health.
Incorporate Hydrating Foods: Apart from water, include foods with high water content in their diet, such as cucumber, tomatoes, spinach, and melon. Avoid sugary drinks like fruit juices, syrups, and fizzy beverages.

3. Opt for Healthy Packed Meals

Packing your children's meals has several advantages, including saving time and reducing their exposure to potentially contaminated surfaces at the school canteen. Focus on these guidelines for their meals:

Include Fruits: Incorporate fruits into their meals as they are easy to prepare and healthy. Toddlers need about 1 cup of fruit per day, while older children require 1.5 cups.
Add Vegetables: Mix vegetables with rice, pasta, or noodles in their bento boxes. The recommended daily intake varies by age and gender, but including a variety of colorful vegetables is essential for their health.
Protein: Ensure your children receive an adequate amount of protein, with fish, nuts (for those above 5 years old), and other protein sources.
Milk: Include three servings of milk or dairy products per day for children under 5. After 2 years, switch to semi-skimmed milk.

4. Gradually Introduce Healthy Foods

Introducing a variety of healthy foods to your children can be a rewarding journey. Here's how:

Step-by-Step Approach: Start by introducing one category of food per month. For example, focus on fruits in August and gradually expand their preferences.
Build on Favorites: Begin with foods your children already enjoy and then introduce variations within the same food category.
Consider Nutritional Supplements: If your children are picky eaters and you're concerned about their nutrition, consult a healthcare professional about appropriate vitamins and supplements. These can help compensate for any macronutrient and micronutrient gaps in their diet.

In conclusion, by following these guidelines and fostering healthy eating habits, you can help boost your children's immune systems and overall well-being, ensuring they have a healthy and happy school experience. Always consult with healthcare professionals for personalized advice on your children's dietary needs

References

World Health Organization (WHO). Healthy at home. Tips for maintaining healthy diet. https://www.who.int/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome—healthy-diet (Accessed in July 2020).
World Health Organization (WHO). Feeding babies and young children during the COVID 19 Outbreak. http://www.emro.who.int/nutrition/nutrition-infocus/feeding-babies-and-young-children-during-the-covid-19-outbreak.html (Accessed in July 2020).
WebMD. 6 Vitamins and Minerals your kids need. https://www.webmd.com/health-insurance/features/family-vitamins#3 (Accessed in July 2020).
Harvard School of Public Health. Nutrition Insurance Policy: A Daily Multivitamin. https://www.hsph.harvard.edu/nutritionsource/multivitamin/ (Accessed in July 2020)

Kids and vegetables

According to study from National Health Morbidity Survey (NHMS), 95% of Malaysians do not eat enough vegetables daily! That is three serving per day (1).

This is not surprising, since in Malaysia if we look around us, we are still lacking healthy food option. For your information, the nationwide study mentioned above was conducted among adult above 18 years old (1). From this study you may deduce that how can our younger generation be able to consume vegetables if their parents or adults around them do not consume it?!

Anyone knows that the best food rich with all the micronutrients, macronutrients, and antioxidants are coming from plant-based food. Many studies have tried to use plant-based diet as an intervention method for various kind of diseases especially chronic diseases, and it works wonder! Thus, instead of using plant-based diet as an intervention when people are already sick, why not cultivate the habit of eating vegetables and fruits since young. The stigma that healthy food is not palatable and not delicious is way too yesterday for our brand-new generation. As an exemplary adult, we need to portray that eating healthy food and living a healthy lifestyle is the new cool!

Now, if you are parents or caregivers below are some tips you may try to make your children love vegetables. Remember, however it all start with you, you first must cultivate it then it will be easy peasy lemon squeezy for your children!

Tips #1 (2)

Provide fruits and vegetables as snacks. Keep fruit washed, cut up and in plain sight in the refrigerator. You may also make it compulsory for your family to eat vegetables every family time, it can be as simple as salad with dressings. You also can try and be creative by including at least one leafy vegetable for vitamin A such as spinach, broccoli, winter squash, and greens. As for fruits, try to include at least one vitamin C rich fruit such as guava, oranges, melon each day. You may also add vegetables as sides ingredients in your noodles, pasta, fried rice, cereals etc. If you are eating out, order vegetarian’s menu or simply greens in every meal either as side dish or as main, will also help!

#Tips 2 (2)

Another thing that you can start doing is when you buy your food stock. Includes your child fruits and vegetables preference when buying groceries. When shopping for food, start in the area of fresh fruits and vegetables. Avoid buying high-calorie foods such as chips, cookies, and candy bars. Your child may not ask for these treats if they are not in sight. Limit or eliminate how much fruit juice you give your child and make sure it is 100% juice, juice ‘drinks’ with plenty of sugar. Eat together whenever possible also helps in cultivating healthy food habit, since research shows that kids eat more vegetables and fruits and less fried foods and sugary drinks when they eat with their entire family.

#Tips 3 (3)

You may also try to consume kids’ friendly veggies and fruits recipe. Include your child in the process of making, will also help in making them interested with fruits and vegetables. These are some of things you can try in order to make your child enjoy vegies;

Smoothies creations, you can blend yogurt or milk fruit pieces and crush ice. Use fresh fruits in the smoothie, you may use fruits like bananas, berries, peaches, and/or pineapple. If you freeze the fruit first, you don’t even have to use ice!

Delicious dippers, this is something that you can try to create at home, make your own salad dressings using herbs or garlic. Serve the dressings with raw vegetables like broccoli, carrots, or cauliflower. Fruit chunks go great with yogurt, cinnamon, and vanilla dip!

Personalized pizza is also something that you can create at home, you may use pita bread as the crust, or you can also buy the ready to eat pizza crust, and prepare variety kind of vegetables for the pizza. Vegetables like, bell pepper, broccoli, mushrooms, spinach, all sorts. Let your kids explore the ‘cooking’ and eat together will help in cultivating the habits of eating vegetables.

Caterpillar kabobs assemble chunks of melon, apple, orange, and pear on skewers for a fruity kabob. For a raw veggie version, use vegetables like zucchini, cucumber, squash, sweet peppers, or tomatoes.

In conclusion,

You can try and be creative as much as you can to develop your child habits of eating vegetables and fruit, but the most important one would be you have to be the role model yourself!

References

National Health Morbidity Survey (NHMS) (2019). Ministry of Health Malaysia (MOH).
American Academy of Paediatrics (AAP). Healthy Children Organization. How to get your child to get more fruits and veggies.(Latest update 27/8/2020.
United States Department of Agriculture (USDA). 10 Tips: Kid-friendly veggies and fruits. https://www.choosemyplate.gov/ten-tips-kid-friendly-veggies-and-fruits (Accessed on November 5, 2020).

Milk: A Nutrient Powerhouse with Controversial Health Implications

Milk is renowned as a nutritional powerhouse, often considered the food with the highest nutrient density, making it a natural dietary staple for infants from ancient times. This association continues to hold true, as milk is the preferred oral nutrition supplement for bedridden patients (1).

Nonetheless, the role of milk in adult diets remains a topic of debate. Some studies argue that daily milk consumption is unnecessary, while others advocate for its regular inclusion (1). Here, we present a breakdown of the considerations to help you decide whether daily milk intake is right for you.

Milk and Obesity

Despite the common perception that full-fat dairy products contribute to weight gain, research has revealed a contrary perspective. In fact, full-fat dairy products might be more effective in weight management than their low-fat counterparts. Walter Willet, a nutrition expert from Harvard School of Public Health, clarifies that the demonization of all fats emerged in the 1950s and 1960s when saturated fats were linked to high cholesterol and increased heart disease risk (2).

However, reducing saturated fat in food products or diets often leads to their replacement with sugars or carbohydrates. The downside to this substitution is that carbohydrates do not provide the same feeling of fullness as fats, causing increased food consumption (2). Some studies even suggest that the more sugar we consume, the stronger our cravings become, akin to an addiction (3).

Modern Milk Dilemma

Modern milk options have evolved to cater to various preferences and dietary needs, from animal-based milk to plant-based alternatives. The variety of choices makes selecting the right milk a bit tricky, especially given the differing nutritional profiles.

Choosing the Right Milk

If your goal is to use milk to promote a sense of fullness and avoid excessive food intake, full cream milk is a suitable choice. However, be mindful of monitoring your overall calorie intake and opt for milk with lower sugar content. On the other hand, if you tend to obtain fats from other food sources, opting for low-fat milk is advisable while remaining vigilant about sugar content. In essence, prioritize milk with minimal sugar, saturated fat, and trans-fat content, as these components have been associated with various health complications.

Plant-based milk alternatives may not necessarily be healthier than cow's milk, as they could contain higher sugar levels. However, they are an environmentally friendly choice, with soy milk, almond milk, oat milk, and rice milk producing fewer carbon emissions and greenhouse gases compared to cow's milk.

Pros and Cons of Milk

The decision of whether to incorporate milk into your daily diet remains a subject of debate. Factors such as your dietary intake and body weight play a pivotal role in determining the daily milk consumption that suits you. For individuals with normal weight, one glass of milk per day may suffice, while those who are underweight might consider upping their intake to two glasses. Yet, it is essential to balance the intake of beneficial fats from milk with the reduction of harmful fats from sources such as deep-fried foods, foods high in trans-fats, and those with high saturated fat content.

In Malaysia, where a significant portion of the population is overweight or obese, reconsidering daily milk consumption may be prudent. The key is to ensure you meet your daily calcium requirements, which can also be obtained from alternative sources like anchovies, sardines, almonds, kale, and various other foods (5,6).

Fact Check (5,6)

Saturated fat is often high in animal-based and certain plant-based foods, such as coconut milk (santan). Excessive intake is linked to elevated blood cholesterol levels and an increased risk of heart disease. Notably, many coconut milk products claim to be cholesterol-free, despite containing high levels of saturated fat.
Trans fat is a man-made fat produced through hydrogenation, which raises bad (LDL) cholesterol and lowers good (HDL) cholesterol levels. Consuming trans fats increases the risk of heart disease, stroke, and type 2 diabetes. Examples of foods that may contain trans fats include doughnuts, cookies, crackers, muffins, pies, fast food, and cakes.

References

Ask the Experts: Is Milk is good for you? https://www.healthline.com/health/food-nutrition/experts-is-milk-good-for-you (Accessed on November 23, 2020).
Harvard T.H. Chan School Public Health. Calcium and Milk. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-and-milk/ (Accessed on November 24, 2020).
Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and biobehavioral reviews, 32(1), 20–39. https://doi.org/10.1016/j.neubiorev.2007.04.019
Harvard T.H. Chan School of Public Health. Milk not necessary for adult, should be good option for kids. https://www.hsph.harvard.edu/news/hsph-in-the-news/milk-health-adults-kids/ (Accessed on November 20, 2020)
Ministry of Health (MOH). Fats and cholesterol. http://www.myhealth.gov.my/en/dietary-for-hypercholesterolemia/ (Accessed on November 23, 2020).
American Heart Association (AHA). Trans Fat. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/trans-fat (Accessed on November 24, 2020).

Boost your kids’ immune health

In this pandemic COVID19 era, people have started to consume foods which can boost their immunity. People have started to practice wearing mask in public, normalize social distancing and some even goes to the extent of not exposing children in public places for the fear of virus spreading. We know that children are even fragile than us adult, thus taking extra care for them especially children who fall sick easily is a must for parents in this COVID19 situation. Here we share with you some tips that you can practice to boost your children immunity system!

Guard against germ spread.

Fighting germs does not technically boost immunity, but it is a great way to reduce stress on your child’s immune system. Make sure your children wash their hands often (with soap) especially before and after using toilet, before and after meals, after playing outside, arrive home from day care, handling pets, or blowing their nose. To cultivate the habits, you may also let them pick up their own choice of handkerchief, soap, and scents!

You must also always make sure that your hands are clean before you touch them!

Whenever you are bringing them outside make sure you carry antibacterial disposable wet wipes with you for your quick clean ups. Oh, you may also practice to let your children wear face shield if you are outside or in public area if they cannot wear mask yet! Make sure to sanitize or clean the face shield frequently and keep it properly as well!

Another key germ busting strategy according to health professionals is whenever your child is sick throw away their toothbrush as the germs from outside or from the toothbrush can hop from toothbrush to toothbrush infecting other family members. If it is a bacterial infection, such as strep throat, your child can reinfect themselves with the same germs that got them sick in the first place. In that case, tossing the toothbrush protects both your child and the rest of your family.

Make sure your children eat healthily.

It is normal for kids to dislike healthy foods if the parents dislike it, or rarely consume it! If you feel like your children eating habit are more into unhealthy habit check back your food preference most of the times it is a reflection!

Try to eat healthily as much as you can, make sure that every main mealtime there is vegetables and fruit serve for your whole family, it can be just a simple blanched carrot and broccoli, or it can be stir fried vegetables or it can be simply raw salad with dressings! If your children are okay with consuming vegetables and fruits in every main mealtime, start introducing healthy snacks using fruits and vegetables as well.

They may eat cakes, biscuits, and dessert occasionally still! If your children are still below 6 months young, try to breastfeed them as much as you can, as breastmilk has naturals antibody which is passed from mothers to baby which is beneficial for children during this pandemic situation.

Apart from vegetables and fruits, consuming yogurt which contains high amount of probiotics and prebiotics also helps with immune health.

Boost sleep time!

Studies show that sleep deprivation make individuals more susceptible to illness by reducing natural killer cells (immune-system weapons that attack microbes and cancer cells). Required sleeping hours for children is vary according to their age, but on average children need to nap during the day for at least one hour and sleep throughout the night for at least 10 hours.

Try to help your children into having a fixed routine helps with their sleeping time. Try to tone down screen time and makes them do a lot of physical activity in the evening also helps with sleeping earlier during the night. Children who does not nap during the day may sleep even earlier at night according to expert, but still nap is important for children, which is why try to cultivate habits which makes them easier to nap during the day. This will not only be beneficial for their immunity but as well as for their growth and development.

References.

7 Ways to Boost Immunity for your child’s Immunity. https://www.parents.com/health/cold-flu/cold/boost-childs-immunity/ (Accessed on Feb 15, 2021).

Cleveland Clinic. Health Essentials. How to boost your kids’ immunity heading into the new school year. https://health.clevelandclinic.org/how-to-boost-your-kids-immunity-heading-into-the-new-school-year/ (Accessed on Feb 15, 2021).
Grow by WebMD. Immunity bosting snacks for kids. https://www.webmd.com/parenting/features/immune-system#1 (Accessed on Feb 15, 2021).

Constipation in Children: What to Do?

Constipation is common among children. As parents, you may notice that your child has constipation if:

They have not pooped in at least three days.
Their poop is large and hard; it looks like rabbit droppings or little pellets.
They are straining or in pain when they poop.
They may have some bleeding during or after pooping because their poop is hard.

Another sign to look for is when a child has a poor appetite or stomach pain that improves after they poop. Soiled pants are one of the symptoms of constipation in children aged one and up, as runny poop may leak around the hard constipated poop. This is called overflow soiling.

Constipation is common in toddlers aged 2 to 3 years old, according to health professionals. This is because usually at this age, parents start to potty train their children, which makes them feel uneasy about the whole poop situation.

Here are some tips that you may try to prevent your child from experiencing constipation or to help them while they are constipated.

Make sure they drink plenty of fluid. Most of the time, children are unable to tell you if they are thirsty, especially if they are merely 1 year old. One of the tips that we can practice is to always make sure their sippy cup is full and within their reach so that it will be easier for them to drink water whenever they want. Sometimes children are so occupied with playing that they do not drink water, so it is best to remind them every few hours to drink water.
Consume a high-fiber diet. This means to load your child's plate with plenty of fresh fruits and vegetables, high-fiber cereals, whole-grain breads (look for at least 3-5g of fiber per serving), and a variety of beans and legumes, such as lentils and chickpeas. One of the good sources of fiber that children love most is popcorn (but prepare it with the minimum amount of sugar, butter, and salt). You may also let them prepare their own popcorn or fruit salad; this will even stimulate their appetite, and of course they will learn and enjoy the process. Foods containing probiotics, such as yogurt, can also promote good digestive health.
Doing a lot more physical activity. Sedentism can also be detrimental to bowel movements. Children under the age of five require at least three hours of physical activity per day. So, let them move around, let them jump and climb, but keep in mind that all of this must be monitored and done in a safe environment, especially for young toddlers.
Regular toilet time. This is especially true for children who are undergoing toilet training. Encourage your child to use the toilet first thing in the morning and after every meal or snack. Set a timer for every 30 to 45 minutes to take them to the bathroom. Instead of suggesting, "Do you need to go to the bathroom?" simply say, "Time to go to the bathroom now." Having regular toilet time also means helping them have regular time for everything else, such as their mealtimes and their naps. This will also help them easily adapt to this new habit of going to the toilet whenever they feel the urge.
Stool softener to clear the bowels. These are safe for children, but they need to be used under the supervision of a doctor or pharmacist. A common mistake when it comes to using stool softener is that parents tend to stop using it after their child has their first normal-looking bowel movement, but stopping too soon may just set your child up for another episode of constipation. So, what you can do is talk to your doctor; it is okay to let your child stay on stool softener for a few weeks. At the same time, try your best to cultivate lifestyle and dietary changes that can improve your child's bowel movements.

In conclusion, always try to monitor your child's bowel movements so you may notice any changes, especially if they are under 2 years old, as they cannot verbally tell what is going on in their body or if they are in pain. Noticing it early will allow you to better prepare to assist them in relieving their bowel condition than if it is already chronic. Also, if it has been too long already or if your child is in pain whenever you press their abdomen (to this extent), it is best to seek advice from a doctor regarding your child's condition.

References.

National Health Service (NHS) U.K. Constipation in children. https://www.nhs.uk/conditions/baby/health/constipation-in-children/ (Accessed on April 1, 2021).
National Institute of Diabetes, Digestive and Kidney Disease (NIDDK). U.S Department of Health and Human Services. Symptoms and Causes of Constipation in Children. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation-children/symptoms-causes (Accessed on April 1, 2021).
Mayo Clinic. Constipation in Children. https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242#:~:text=Constipation%20in%20children%20is%20a,constipation%20in%20children%20are%20temporary. (Accessed on April 1, 2021).

Diarrhea in children and what need to be worried about?

Diarrhea is characterized by frequent soft or loose bowel movements (poop). Most children experience diarrhea from time to time. It usually does not last long and usually resolves on its own, but in children, the period when they have diarrhea is critical because they may be losing too much water, which can lead to other health problems.

Among the dehydration symptoms that parents and/or caregivers should look for in children who have diarrhea are:

Seems drowsy
Breathes quickly
Has few or no tears when they cry
Has a soft spot on their head that sinks inwards (sunken fontanelle)
Has a dry mouth
Has dark yellow pee or has not had a pee in the last 6 hours (for baby) and 12 hours (for child)
Hands and feet that appear cold and blotchy

Diarrhea is usually caused by an infection, such as rotavirus, bacteria like salmonella, or a parasite like giardia. Aside from dehydration symptoms, it also includes vomiting, stomachache, headache, and fever.

It is also critical to seek medical attention right away if your child or baby exhibits any of the following symptoms:

A fever of 38°C or higher.
Diarrhea lasting more than 24 hours.
Has more than four diarrhea stools in eight hours and isn't drinking enough.
Bloody or pustular stools

It is best to prevent fluid loss when treating diarrhea in children or adults, whether in a clinical setting or at home.

Here are some tips that parents and/or caregivers can use to prevent fluid loss at home:

Provide more fluids and encourage your child to drink more. Infants and children should be given extra breast milk or oral rehydration solution (ORS). Plain water lacks minerals like sodium and potassium, both of which can help with diarrhea. Fruit juice and carbonated drinks are not recommended because they cause stomach ache/ cramps and increase fluid loss (the later). Children with severe diarrhea, vomiting, and dehydration may require intravenous fluids (via a vein in the arm) in the hospital.

It is also critical to begin providing a consistent diet for the children. Encourage them to eat small amounts of food frequently, even if they don't have an appetite. Breastfed babies can continue to nurse normally, and formula-fed babies can eat normally as well. Smaller, more frequent meals are once again encouraged. Water-rich foods, such as watermelon, are also encouraged.

In conclusion, diarrhea in children can be very serious and is quite common; some of the practices that parents may employ when dealing with children who frequently experience diarrhea include ensuring that their children's and caregiver's hygiene is always maintained. Ensure that food is stored at the proper temperature, particularly dairy and raw food products; that food is fully cooked; and that the home environment is clean, especially if there is a pet in the same household. Aside from these, taking probiotic supplements is beneficial to their gut health.

References

American College of Gastroenterology. Diarrhea in children. https://gi.org/topics/diarrhea-in-children/ (Accessed on April 1, 2021).
National Collaborating Centre for Women’s and Children’s Health (UK). Diarrhoea and Vomiting Caused by Gastroenteritis: Diagnosis, Assessment and Management in Children Younger than 5 Years. London: RCOG Press; 2009 Apr. (NICE Clinical Guidelines, No. 84.) 5, Fluid management.Available from: https://www.ncbi.nlm.nih.gov/books/NBK63837/
National Institute of Health (NIH). National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK). Symptoms and causes of chronic diarrhea in children. https://www.niddk.nih.gov/health-information/digestive-diseases/chronic-diarrhea-children/symptoms-causes (Accessed on April 1, 2021).
National Health Service (NHS) U. Dehydration. https://www.nhs.uk/conditions/dehydration/ (Accessed on April 1, 2021).
Diarrhea in Children. https://www.webmd.com/children/guide/diarrhea-treatment (Accessed on April 1, 2021).

Children and repeated infections

Whenever, a child frequently being infected it makes parents worry a lot. According to study on average children get infected about 4 to 8 times annually. A big why for this is because they spend most their time at school or in day-care centers where they are in close contact with other kids most of the day. Also, it partly because kids are not conscientious enough about covering sneezing with elbow or frequent hand washing. Apart from this, it is also because their young immune systems are still developing and not strong enough to fight colds.

However, it is not practical to avoid your children from all the exposure altogether since exposure to all these things are somewhat things that build up their immune health stronger and better, but we must control the exposure and make sure that their immune health is strong enough to fight the infection.

Here are some tips that you may practice to help your children to stay as healthy as possible:

Make sure that your child get all the required vaccines under the National Immunization Program. You may also add more vaccines based on your child condition and needs but talk to your pediatrician first!

Make sure that your child is getting the nutrition that they need to help them with their immune system. Ensure that your child get enough protein, fiber, vitamins, and minerals. Minimize sugar and processed foods as their tummy is only little if they fill it with all these unhealthy stuff they will have no appetite anymore for nutritious foods. Encourage children to consume fruits such as orange, kiwi, and guava that is rich with vitamin C. Limit the intake of dessert, sugary drinks, sausage, meatballs etc.

Discourage the habit of thumb sucking or using pacifier as your infant gets older, as a contaminated finger, thumb, or pacifier can be a route for germs transmission which can lead to infection.

Always keep your child’s utensils and bottle clean. If you are still breastfeeding your child, or is using breastmilk pump, make sure you frequently boiled it, or steam all the equipment.

Try to instils good hygiene practice since young, such as wash hands as soon as reach home, after going to the toilet, and whenever they sneeze or cough and covered it with their hand.

Most importantly, understand that frequent infections are very common in the first two years of life especially if they are in day care with many other children and after they no longer breastfed. All in all, all these will help them to make their immune health better but at the same time as a parents we need to help the children to build their immune health by providing nutritious foods, clean environment and instill good hygiene practice.

Understanding acid reflux in children

Acid reflux, also known as gastroesophageal reflux (GER), is a condition that affects both adults and children. While the fundamental mechanism remains the same, there are notable distinctions between acid reflux in adults and its manifestation in children.

In adults, reflux occurs when stomach contents, including stomach acid, flow back into the esophagus, leading to symptoms such as heartburn, regurgitation, and a bitter taste in the mouth.

This uncomfortable condition is not limited to adults; it can also affect children and even infants. However, due to the differences in the maturity of their digestive systems, the symptoms of GER can vary significantly depending on the child's age.

In infants, a certain amount of spit-up after feeding is common and referred to as GER. Nevertheless, if your baby experiences frequent vomiting accompanied by discomfort, feeding difficulties, or weight loss, it may signify a more serious issue than typical GER. Nevertheless, the underlying mechanism of GER in babies, children, and adults remains quite similar.

For babies, GER often results from their underdeveloped gastrointestinal tract, which is not as coordinated as an adult's. In contrast, children may experience GER due to factors like obesity, overeating, consumption of spicy or oily foods, intake of caffeinated or carbonated beverages, or the use of specific medications. Nonetheless, the root cause of GER in children is akin to that in adults: it occurs when factors induce relaxation of the muscular valve between the stomach and esophagus (known as the Lower Esophageal Sphincter or LES) or elevate pressure below the LES.

Symptoms in Children:

The most common GER symptoms in infants and children include:

Frequent or recurrent vomiting
Persistent cough or wheezing
Feeding difficulties, such as choking or gagging during meals
Heartburn, gas, abdominal pain, and colic
Regurgitation and re-swallowing
Complaining of a sour taste in the mouth, especially in the morning

Tips for Identifying and Assisting Children with GER:

When it comes to children, paying close attention to their complaints or observations is crucial. Children often struggle to articulate their discomfort or pain accurately. In addition to this, there are several strategies that can help manage GER in children:

Encourage children to sit upright for at least two hours after meals, particularly if they have consumed trigger foods like oily or spicy dishes, carbonated beverages, or caffeine.
Opt for several small meals throughout the day instead of three large ones.
Ensure that children do not overeat.
Promote regular exercise among children.

For infants, elevating the crib or bassinet and holding the baby upright for 30 minutes after feeding can be beneficial, along with assisting them in burping.

In conclusion, acid reflux, a condition commonly associated with adults, can also affect children. However, children may struggle to describe their symptoms and understand what is happening to their bodies. The key lies in attentive observation and implementing the helpful tips mentioned above to provide relief and comfort to children experiencing GER.

Asthma in Children

What is asthma in children?

Asthma is a major non-communicable disease (NCD), affecting children and adults. It is a condition in which the airway in the lung narrows due to inflammation and tightening of the muscle surrounding the small airway. As a result, asthma symptoms such as coughing, wheezing, shortness of breath, and chest tightness developed. These symptoms are usually on and off, while the asthma disease itself is a long-term condition. Asthma triggers vary from person to person, but they can also be due to a viral infection (cold), dust, smoke, fumes, changes in the weather, grass and tree pollen, feathers, strong soap, perfume, animal fur, and many more.

Causes of asthma in children.

Although it is often difficult to find a single, direct cause, it is believed to have multiple complex causes. Many factors have been linked to an increased risk of developing asthma, such as

Have a close family member with asthma and/or eczema, such as parents or siblings
Have other allergic conditions such as rhinitis, etc.
Urbanization is associated with increased asthma prevalence, probably due to multiple lifestyle factors.
Events in early life affect the developing lungs and can increase the risk of asthma. These include low birth weight, premature birth, exposure to tobacco smoke and other sources of air pollution, as well as viral respiratory infections.
Exposure to a range of environmental allergens and irritants is also thought to increase the risk of asthma, including indoor and outdoor air pollution, house dust mites, molds, and occupational exposure to chemicals, fumes, or dust.

Prevention & Control of asthma

Asthma cannot be cured, but good management with inhaled medications can control the disease and enable people with asthma to enjoy a normal, active life.

There are two main types of inhalers:

Bronchodilators (such as Salbutamol), that open the air passages and relieve symptoms
Steroids (such as Beclomethasone), that reduce inflammation in the air passages. This improves asthma symptoms and reduce the risk of severe asthma attack and death.

People with asthma may need to use an inhaler every day. Their treatment will depend on the frequency of symptoms and the types of inhalers available.

It can be difficult to coordinate breathing using an inhaler, especially for children and during emergency situations. Using a "spacer" device makes it easier to use an aerosol inhaler and helps the medicine reach the lung more effectively.

People with asthma may need to use an inhaler every day. Their treatment will depend on the frequency of symptoms and the types of inhalers available.

Other than this, it is also best to avoid triggers for asthma. Triggers vary from person to person; as asthmatic children grow; parents should be able to identify things that trigger their asthma attack. It can be as simple as changes in weather, temperature, etc.

In conclusion, since asthma is a lifelong disease, it is best to manage or control it by avoiding triggers in children and by adhering to the medication based on a doctor's suggestion.

References

World Health Organization (WHO). Asthma. https://www.who.int/news-room/fact-sheets/detail/asthma
Mayo Clinic. Childhood Asthma. https://www.who.int/news-room/fact-sheets/detail/asthma
Better Health Chanel. Asthma in children. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/asthma-in-children#causes-of-asthma-in-children

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