BTD – Maternal, Infant and Early Childhood Nutrition — The Thousand Day Window of Opportunity

BTD – Maternal, Infant and Early Childhood Nutrition — The Thousand Day Window of Opportunity


[Thorpe] Welcome
to Beyond the Data. I’m Dr. Phoebe Thorpe, and here with me today is Lucy
Sullivan the executive director for One Thousand Days. Hi Lucy, thank you so
much for joining us. [Sullivan] Hi Phoebe. It’s great to be here. Thank you for having me. [Thorpe] Our session today
was about maternal infant and childhood early
childhood nutrition and about the 1000 day
window of opportunity. What is the 1000 day
window of opportunity, and how did you get
involved in it? [Sullivan] Yes. So the 1000 day window of
opportunity refers to the time between a woman’s pregnancy
and a child’s second birthday. And the reason we call it
the window of opportunity is because it’s a real
chance to ensure that babies get a
strong start to life. Nutrition during that first
thousand days plays a critical role in ensuring
mom and baby health and ensuring baby’s development,
that they get a strong start in terms of brain development, and setting the foundation
for lifelong health. The 1000 day window was
actually discovered if you will by The Lancet back in 2008. The British medical
journal The Lancet that identified this minus
9 month to 24 month window and the role, the powerful
role, that nutrition plays in setting the trajectory
for a child’s health and a child’s development. And since then, we have taken
that 1000 days term and tried to really bring greater
awareness to the importance of nutrition to ensure that
every child throughout the world and in the US gets the
nutrition they need to thrive. And for me it was a
professional passion and then became a personal
passion when I became a mother. [Thorpe] Of course. Of course. So let’s start with the
weight gain during pregnancy. Very, nutrition is a very
important part of that. What and the amount of weight that women gave during
pregnancy is very important. What can healthcare providers do to help women understand
the importance of that? [Sullivan] Yeah, I’m so
glad you brought that up. Because, in the US, many
women are entering pregnancy at an unhealthy weight,
and it’s really important that women start out pregnancy
healthy, eating a good diet, and obviously managing
their weight. And once a woman
becomes pregnant, it’s also incredibly
important to ensure that she’s gaining the
appropriate amount of weight, and this is where the healthcare
providers do play a very critical role in
guiding women in terms of the appropriate weight gain,
counseling women on nutrition, on the importance of nutrition, and the foods they
should be eating. In this way, access
to affordable, comprehensive healthcare is
critically important for women to make sure that they
have the opportunity to see doctors during their
prenatal visits and be followed up with in terms of are they
gaining the appropriate amount of weight. There’s actually a
“Goldilocks Zone” if you will in terms of weight gain. We want to make sure that women
are gaining just the right amount of weight, not too
little and not too much, because it’s important
for mom’s own health but also important
for baby’s health. The amount of weight that a
woman gains during pregnancy, what she eats, her nutritional
stores during pregnancy really does have an impact on
the developing child and can set the trajectory for
that child later on in life. What’s happening in that nine
months in pregnancy and then in the first few years of life
really do impact a child’s, for example, predisposition
to certain kinds of chronic diseases like
diabetes and heart disease. And there is some
interesting research showing that the quality of nutrition
during that 1000 day window and the amount of weight
a woman gains as part of that really does have
this this lifelong impact. [Thorpe] So there’s also plenty
of research about the importance of breast-feeding and the
benefits of breast-feeding not, and it’s not just the
research is not just about what for the baby but it’s
for the mom both. What can we do to help
support breast-feeding more? [Sullivan] Yeah. I’m so glad you brought
that Phoebe, and you’re absolutely right. Breast-feeding is
just as important for mom as it is for baby. In moms, it helps reduce
the risk of breast cancer, ovarian cancer, and high
blood pressure, and so, we want to make sure that moms
have the support that they need to get breast-feeding started. So that means really
skilled lactation support in the hospitals, making
sure that hospitals and maternity care facilities
are breast-feeding friendly, and then that means when
she goes home with the baby that she then has the support
that she needs from her partner, from her community,
certainly from her workplace to continue breast-feeding. One of the challenges and one of
the big barriers that women have in this country is that there
is not a national paid parental leave policy that covers all
workers, and so, you have one in four women going back to work within two weeks
of giving birth. And it’s very challenging for
moms to continue to breast-feed in accordance with the AAP
recommendations and the WHO recommendations that babies
be breast-fed exclusively for the first six months. And then when they return to
work, employers need to ensure that there is access to
lactation facilities, so that when moms are pumping
milk, they have a safe, clean space to do so and
store their milk as well. So there’s a lot more we can
be doing to support mothers to breast-feed for
their own health. And then, we haven’t talked yet
about the child health benefits of breast-feeding, but
it’s incredibly important as you know as a pediatrician. And that ranges from
lower infections in terms of ear infections, respiratory
infections, a lower risk of sudden infant death syndrome
which is a leading cause of infant mortality in the US, and so breast-feeding really
is an essential public health investment. [Thorpe] As a pediatrician,
I was delighted to hear about the peanuts, and now
there are new recommendations to for children who are at
high risk for peanut allergy to introduce peanuts to them
even as young as four months. This is a 180 from the
previous recommendations that were given even
just a few years ago, but there are many other
important things to know about introducing foods
to your young infants. Can you tell me about
some of those? [Sullivan] Sure. The most important thing is to
introduce a variety of foods and textures into an infant’s
diet, and that means fruits, vegetables, and meats. Meats are actually important
from an iron standpoint. Iron is a key brain
building nutrient, and so, we want to make sure that
babies are getting enough iron in their diets when they
start eating solid foods. Unfortunately, 1 in 4 1
year olds in this country 1 to 2 year olds aren’t
getting enough iron, and that is certainly a concern and something we
need to be watching. The other thing that’s
important is that parents have the
information that they need to make decisions about
what they should be feeding and not feeding their babies, and this is where I think
the dietary guidelines that are currently under development will
be incredibly helpful. So for the first time ever, the US government is developing
a set of dietary guidelines for pregnant women and children
under two, and that is going to be I think a really
helpful source of information for parents. We at Thousand Days
know that about half of parents we’ve surveyed
get mixed messages on what to feed their baby and
how to feed their baby. So there definitely is a hunger
for this kind of information. Those dietary guidelines
are also going to serve as an important reference
point for the women and children program which
is a program that serves about half the babies
born in this country, and it’s a critical program
particularly for families that that are living
in food insecurity. And we know that food insecure
families, the diets tend to be a little bit less
on nutrient rich, and so, when we think about
babies and toddlers living in low-income families,
we want to make sure that those babies are getting
the wide variety of foods that we just talked about
into their diet to ensure that they also have a
strong start to life. [Thorpe] Sure. That makes sense. So if people want to know
more about all of these things where would you tell
them to look? [Sullivan] So a great
place to start is of course the CDC website and
the resources that CDC has on breast-feeding and
complementary feeding. We at Thousand Days also
have resources for parents to better understand
what to feed your baby, and how to [Thorpe] When. [Sullivan] feed your baby,
when to feed your baby, so you can check
out our resources, our website at thousanddays.org. And then I think beyond
that, the women infant and children program the
Witten program [Thorpe] Sure. [Sullivan] that serves so many
families in the United States. They have breast-feeding
counselors, and they are a great
source of advice for nutrition information, and
a great resource for parents. So hopefully, parents can find
the information that they need, and as I said the
dietary guidelines… [Thorpe] Are coming out. [Sullivan] Forthcoming. [Thorpe] That’s right. [Sullivan] 2020. [Thorpe] 2020. [Sullivan] Will be. [Thorpe] Posted on the web too. [Sullivan] Yes. [Thorpe] Yeah. [Sullivan] A terrific resource. [Thorpe] Lucy, thank you
so much for joining us. [Sullivan] Thank you Phoebe. It’s a pleasure being here. [Thorpe] And thank you so much for joining us for
Beyond the Data. We’ll see you next month.

Add a Comment

Your email address will not be published. Required fields are marked *