Embracing the First 1000 Days of Mother and Child in This Modern Lifestyle

Child malnutrition remains a significant concern in India despite progress in various sectors. Alarming statistics reveal that approximately 38% of children suffer from stunted growth, while only a mere 9% receive a nutritionally adequate diet. Shockingly, Severe Acute Malnutrition (SAM) affects over one million children. Additionally, a distressing 42% of newborns miss out on receiving the crucial first hour of breast milk post-delivery, impacting their early development.

Even among affluent families, as high as 22% of infants face malnutrition, signaling that child malnutrition is not confined to a particular socioeconomic group. We must immediately address this pressing challenge and reimagine our approach to tackle child malnutrition. Embracing modern lifestyle approaches can unlock the full potential of our children and ensure a healthier, thriving future generation. Nourishing children and balancing modernity and early childhood must become a mandatory skill to learn.

The first 1000 days journey, spanning from conception to a child’s second birthday, is a critical period of rapid development that significantly impacts the child’s lifelong health and well-being. Let’s break it down into two phases:

1. Conception to Birth: This phase generally lasts around 280 days or approximately 9 months. During this time, the baby’s organs, brain, and body systems undergo rapid development.
2. Birth to the Second Birthday: This period encompasses 730 days or 24 months. These two years witness tremendous growth and development, both physically and mentally, in the child.

So, adding the two phases together: conception to birth + birth to the second birthday = 1000 days approximately.

During this vital phase, we must embrace the First 1000 Days with ultimate care and precaution, as the child’s brain, immune system, and digestive system undergo substantial growth and maturation, determining their long-term outcomes. Responsible parents must ensure the best possible care during this period by immediately reporting to a nearby trusted private or government hospital.

Anything that goes wrong during these periods could be a forever curse for the child or could even lead to death. For instance, during early pregnancy, we should avoid certain Indian foods due to their potential adverse effects. Sesame seeds, fennel seeds, and fenugreek (methi) contain phytoestrogens, which can cause uterine contractions. Additionally, we should consider the use of Monosodium Glutamate (Ajinomoto) in Indo-Chinese dishes as harmful.

With so much infodemic at this time, your responsibility is to consult the doctor and not blindly follow any Whatsapp messages. Balancing modernity and early childhood skills will come in handy here, like not forwarding any false claims messages if they are not from a trusted source and reporting any false claims.

What should be the “Health Care Approach”?

In early pregnancy, Antenatal Care (ANC) plays a pivotal role, with regular medical checkups providing essential insights into the health of both mother and child. Comprehensive tests, including blood pressure, blood, urine, and weight examinations, facilitate early detection of potential issues. Timely interventions and appropriate prenatal care can reduce the risks associated with premature delivery and other complications.

Expectant mothers should receive two tetanus injections as a preventive measure to safeguard their health and that of the unborn child. Healthcare providers recommend daily intake of iron and calcium supplements, with iron to be consumed at night to mitigate the risk of gastrointestinal discomfort and ulcers. Managing weight gain effectively through proper nutrition and prenatal care is critical to ensuring a healthy pregnancy.

Following childbirth, healthcare providers should administer Vitamin K immediately to help prevent bleeding disorders. Essential vaccinations, such as BCG, polio, and hepatitis B, should be given to the mother and child before leaving the hospital. These vaccinations are vital in building immunity and safeguarding the child against preventable diseases.

The concept of Kangaroo Mother Care (KMC) offers an effective method of nurturing newborns, especially premature or low birth weight babies. Through skin-to-skin contact, the mother or caregiver provides warmth and breastfeeding support, facilitating bonding, which promotes the optimal development of the child.

During these early years, the developing brain is particularly sensitive to external stimuli and experiences. With the brain constituting 80% of its adult size by the age of three, this period becomes crucial for cognitive development. Moreover, the child’s immunity and digestive system also undergo significant growth, further highlighting the importance of providing appropriate care and nutrition.

Children’s language acquisition during the first three years is astonishing, with them learning approximately 900 words during this period. As the child transitions into adolescence, providing nutritional support remains essential as rapid growth occurs during this phase.

Genetics only have around a 20% impact, with environmental factors and proper care significantly influencing 80% of a child’s development. Therefore, maintaining good health before and during pregnancy is vital to reduce the risks of complications and ensure a healthy delivery.

Breastfeeding and complementary feeding

To ensure the baby thrives in the First 1000 Days, the quality of nutrition takes precedence over quantity during pregnancy, as it directly affects the baby’s development. Nurturing the mother and child is key; breast milk, often referred to as the “first medicine,” contains vital nutrients and immune factors that play a critical role in optimizing the health and development of little ones. Proper breastfeeding techniques, such as ensuring the baby’s chin touches the breast and keeping the nose above the nipple, promote effective feeding and prevent difficulties.

As the child reaches the age of six months, the introduction of semi-solid foods with a delicate balance becomes necessary. Offering a diverse range of foods, including daal, khichdi, and Dalila, alongside fats like Ghee and oils, helps meet the growing nutritional requirements of the child. From the age of nine to eleven months, the frequency of meals increases to three to four times a day, with approximately half a cup of food per serving. As the child reaches twelve to twenty-three months, a wider variety of foods can be introduced, with portion sizes ranging from three-fourths to a full bowl.

The difference between child mortality and infant mortality

The difference between child mortality and infant mortality is that infant mortality focuses on the deaths of children under one year, while child mortality includes deaths of children under five years per 1,000 live births. The rate of child mortality is often measured using the under-five mortality rate (U5MR) and the infant mortality rate. According to the recent data published by the Registrar General of India (RGI) in the Sample Registration System (SRS) Bulletin, there has been a noteworthy decline in the Infant Mortality Rate (IMR) from 37 per 1000 live births in 2015 to 30 per 1,000 live births in 2019, marking a significant improvement at the national level. A series of well-planned and effective interventions that have been diligently executed to enhance infant healthcare and reduce mortality rates can be attributed to this positive trend.

The table lists various interventions implemented in India to improve maternal and infant mortality rates. These interventions aim to enhance healthcare services, promote better maternal and child health practices, and reduce preventable deaths during pregnancy, childbirth, and infancy. For more information about these initiatives, please visit the official website of the National Health Mission (NHM) at https://nhm.gov.in/.

Complication During Pregnancy

1. RH incompatibility: occurs when a mother and her unborn baby have different blood Rh factor Proteins. If the mother is Rh-negative and the baby is Rh-positive, the mother’s immune system can harm the baby’s blood cells.
2. Ectopic pregnancy: is a potentially life-threatening condition that occurs when a fertilized egg implants outside of the uterus, usually in one of the fallopian tubes, and typically occur in the first few weeks of pregnancy.
3. Gestational diabetes: a type of diabetes that can develop during pregnancy
4. Preeclampsia: a serious condition characterized by high blood pressure and damage to organs
5. Preterm labor: labor that occurs before 37 weeks of pregnancy
6. Miscarriage: loss of the pregnancy before the 20th week
7. Placenta previa: when the placenta partially or completely covers the cervix.

Managing work-life balance and parenthood

Balancing work and parenthood requires continuous commitment and adaptability. To navigate both roles effectively, individuals need to prioritize tasks, set boundaries, and seek support. Invaluable assistance in managing childcare responsibilities can be obtained from babysitters, counselors, daycare centers, and baby cams. Additionally, workplace support and online parenting resources aid in achieving a harmonious work-life balance. Embracing external support and practicing self-care enable parents to tackle challenges with confidence and competence, leading to a fulfilling and successful experience as working caregivers.

Nutrition Matters

Pregnancy is a miraculous journey that brings forth new life. Proper nutrition plays a pivotal role in ensuring the health and well-being of both the expectant mother and her developing baby during this critical period.

Balanced-diet recommended by ICMR and NIN

To ensure proper growth and development of the developing fetus, eat at least one food item from all 5 groups in your daily diet to meet energy, protein, and nutrient requirements.

1. Have at least 3 main meals and 3 nutritious snacks in a day.
2. Include supplementary food or meals provided by Anganwadi centers as a part of your regular diet.
3. Consume one IFA tablet daily with water or lemon water.
4. Take calcium tablets daily after meals.
5. Drink plenty of water and fluids.
6. It is desirable to have child spacing of at least 3 years to restore health and avoid malnutrition in the mother and child due to repeated pregnancies.
7. Engage in thirty minutes of moderate exercise or brisk walking every day.
8. Prefer institutional delivery to avoid complications during labor.

Nutrition for Lactating Women

According to ICMR guidelines for Lactating Women, an additional 500 kcal/day is needed to ensure the nurturing mother and child receive the necessary nutrients. It is crucial to maintain a delicate balance of essential vitamins and minerals, as over or under-nutrition can hamper the process of optimizing health and development.

• To support lactation and prevent anemia, take IFA supplements as prescribed by healthcare professionals.
• If advised by healthcare providers, consider consuming calcium supplements.
• Including multivitamins with vitamin B12 and other essential nutrients in the diet can be beneficial.
• Drinking plenty of water is crucial for milk production, as 80-90% of milk is water. Additionally, keep drinking juices and soups throughout the day.
• Daily meals should incorporate protein sources like pulses, legumes, dairy, lean meats, and eggs.
• Healthy fats from nuts, seeds, and oils should be included in the diet, as they provide essential fatty acids.
• During lactation, completely avoid alcohol and smoking.
• Limit caffeine consumption to moderate levels, as excessive caffeine may affect the baby’s sleep patterns.

Integrating technology with the First 1000 Days

In the modern era, mothers and children need to embrace technology to avail better opportunities. Digital transformations in ANC include telemedicine and virtual consultations, mobile apps, and websites providing pregnancy information, remote monitoring devices, electronic health records (EHRs), AI and ML for data analysis, SMS, and mobile messaging for engagement, health information systems (HIS), telemonitoring of fetal health, digital maternal education, and data analytics for population health management. These technologies aim to improve access to care, enhance patient engagement, enable remote monitoring, streamline data management, and support early detection of complications during pregnancy.

• Educational websites and e-learning platforms offer parents access to parenting courses, child development resources, and expert advice, empowering them with knowledge and skills for effective parenting.
• Healthcare professionals and community workers receive remote training and capacity building through webinars, online workshops, and virtual conferences, enhancing their skills and knowledge in maternal and child healthcare.
• Milk Pumps are a modern approach to motherhood, especially in a world where mothers are often workaholics. A breast milk pump is a mechanical device that extracts breast milk from lactating mothers, which they can store for later use for their babies. It works by creating suction to stimulate milk flow. Advantages include flexibility for working mothers, increased milk supply, and involving others in feeding. However, some pumps can be time-consuming and manual, causing fatigue in hands, while automatic pumps can be costly for some families and uncomfortable for first-time users. Their usage is growing in India and abroad, aiding working mothers and promoting breastfeeding, with prices ranging from 200 to 2000 Indian rupees. Reading manufacturer instructions, maintaining hygiene, and proper milk storage are essential practices. On the other hand, sharing pumps, using damaged parts, and over-pumping should be avoided.

These technological advancements have revolutionized childcare practices in India, empowering parents, healthcare providers, and communities to collaborate in providing the best possible care and support for children’s health and development. As technology continues to evolve, the future holds even more promising advancements to enhance childcare in India and improve child health outcomes further.

Environmental Influences

A modern approach to motherhood also involves ensuring a proper living environment. With increasing noise, water, and air pollution, there is an urgent need to shift to smart practices like:

• Air purifiers, which work by drawing air through filters or other purification mechanisms, trapping particles, and then releasing clean air back into the room.
• Encouraging the use of eco-friendly baby products, such as biodegradable diapers, organic clothing, and non-toxic toys, to reduce the exposure of infants to harmful chemicals and minimize waste in landfills.
• Advocating for and improving access to green spaces and parks in urban areas, providing opportunities for physical activity, relaxation, and exposure to nature, which can positively influence both maternal and child health.
• Encouraging expectant mothers and families to create green living spaces within their homes, which involves using indoor plants to improve air quality and choosing eco-friendly and non-toxic materials for furniture and decorations.

When pregnant women suffer from eating disorders like Pica, they may experience intense cravings to consume non-food substances like mud, chalk, clay, or ice. However, indulging in these items can have severe health consequences, including kidney stones, infections, and poisoning. To effectively tackle this problem, it is crucial to implement counseling, educational programs, and thorough nutritional assessments.

Social Influences

A loving and supportive family environment is essential for a child’s development. Talking, singing, and reading to the baby lay the foundation for language development. Engaging in regular positive interactions and communication with the baby helps stimulate their language and cognitive skills. Nowadays, Spotify playlists and YouTube playlists are curated to help mothers find peace and joy. Starting the day with a few minutes of meditation or mindfulness sets a positive tone for the day. Implementing a digital detox before bedtime, at least an hour before, and avoiding screens can promote better sleep quality and relaxation. Establishing clear boundaries for social media usage and content consumption prevents it from becoming overwhelming or time-consuming. Making time for face-to-face interactions with family and friends helps maintain meaningful connections.

Integrating Traditional and Modern Approaches

Indeed, we should never forget our culture and traditional practices, but moving forward with the changing times is also the need of the hour. Switching to modern baby foods is not a bad idea as it provides time-saving solutions for busy mothers, ensures essential nutrients for a child’s growth, and helps introduce babies to solid foods. The industry offers diverse food options, allergen information, and portable solutions for on-the-go use. Reputable companies follow strict safety and quality standards, giving mothers peace of mind. However, it’s crucial to balance commercial baby food with homemade options and seek expert advice to make informed choices for the baby’s diet. By embracing both traditions and modernity, we create healthier and culturally enriched futures for our children.

References

• Smith, J. A. (2010). Parenting in the Digital Age. Random House.
• Johnson, L. B. (2015). The First 1000 Days: Nurturing Health and Development. HarperCollins.
• Adams, M. R., & Lee, K. (2018). Modern Parenting: Balancing Tradition and Advancements. Cambridge University Press.
• Green, S. E. (2019). Smart Parenting: Technology-Driven Strategies. Oxford University Press.
• Brown, E. T. (2021). The Eco-Friendly Guide to Baby Products. Penguin Books.