By Naazneen Khan, Chairperson of The Infant Feeding Association (IFA)
The first three years – 1 000 days – of any child’s life is critically important in terms of the nutrition it receives. The first 1 000 days equates to the time of conception to the child’s second birthday. This means that apart from nutrition after birth, the nutritional status of the mother at conception and during pregnancy is of great importance to her unborn child.
Due to the rapid physical growth and the development of children’s brains, the correct nutrition during this 1 000-day period can materially affect their short and long-term physical and mental health.
The 1000 Days Organisation cites three crucial stages in the first 1 000 days: pregnancy, infancy and toddlerhood. Their report states that at each stage during the 1 000 day window, the developing brain is vulnerable to poor nutrition—either through the absence of key nutrients required for proper cognitive functioning and neural connections or through the “toxic stress” experienced by a young child whose family has experienced prolonged or acute adversity caused by food insecurity.
One of the serious consequences of undernutrition is also impaired physical development and stunted growth. A child’s mental development can similarly be impaired because infancy is a time of rapid brain development and growth, primarily fuelled by the nourishment a baby receives. During this time, the brain is developing motor functions such as balance, coordination and posture as well as key connections in the brain which enable the child to create and retrieve memories.
When it comes to brain development, breast milk is the ultimate superfood. It contains a variety of nutrients, growth factors and hormones that are vital for a child’s early brain development. Because breastmilk is a living substance with unique components that cannot be replicated in infant formula, its impact on brain development is unparalleled.
There are more benefits. Babies’ brains are shaped not only by the nutrition they receive but also by the quality of the interactions they have with caregivers. Because breastfeeding involves a great deal of mother-child interaction and nurturing, it plays an important role in strengthening a baby’s sensory and emotional abilities, critical for both cognitive and socio-emotional development.
Vital intrauterine development
This focuses on the nutrition a child receives after birth, effectively until its second birthday. However, the nutritional status of the mother before birth is just as important. In this context, we need to look at two stages: firstly at conception and secondly during pregnancy.
The maternal nutritional status at conception influences the trajectory of foetal growth and development. Aspects to consider include a mother’s BMI (her weight relative to her height) as well as her micronutrient status, in particular folate and iron. These factors can influence outcomes such as the risk of pre-term birth and low birthweight.
Secondly, maternal nutritional status during pregnancy can influence organ‐specific growth, foetal body composition and physiological functioning.
Several nutrients play an important role in building the brain during pregnancy. These include iron, protein, copper, folate, zinc, iodine and certain fats. Zinc, in particular, supports the development of the brain and nervous system, while iron impacts nerve fibres, in turn affecting the brain’s processing speed. Long-chain polyunsaturated fatty acids—typically found in breast milk – also play a role in the healthy development and functioning of the brain and eyes.
While these issues are often quite technical, mothers are encouraged to obtain advice from dieticians or child clinics either when planning a pregnancy or when pregnant status is detected.
When breastfeeding is not an option
It is well known that not all mothers are able to breastfeed their babies. Statistics vary across countries and communities and the numbers range from as low as 2% up to more than 10%. Reasons vary and include low breast milk supply and contraindications due to the mother’s medication, amongst others.
For these mothers, this is usually a major problem, but there are ways to get around it. What the IFA suggests is that if a mother cannot breastfeed her child, that she consults a relevant health care practitioner for advice.
The IFA are extremely aware of the consequences if we do not adequately nourish our children and their physical and mental development. Our role is to assist various stakeholders from policymakers, community clinics, medical practitioners, and even parents from the wealthiest to the most impoverished sectors, to become actively aware of the importance of developmental nutrition – especially during the first 1 000 days of an infant’s life.
Child health matters: A life course perspective Shane A Norris,a Lori Lakeb and Catherine E Drapera
Nutrition in the first 1000 Days – A foundation for Brain Development and Learning 1000 Days Organisation.