First 1,000 days shape health for life

New data shows what a woman eats during pregnancy and the newborn's diet till age 2 determine the child's well-being

It's now official — the first 1,000 days of your life — conception to your second birthday is what decides how healthy or brainy you will be the rest of your life. For mothers force-feeding their teenage children with "healthy food" or pushing them to go out to play, scientific evidence now clearly proves that what a mother eats while pregnant influences the child's memory, concentration, judgement, intellect, mood and emotions. 

    Scientists say there are at least 50 brain chemicals or neurotransmitters that are affected by the intake of food and micronutrients by the child in his or her first 1,000 days. The impact of inadequate nutrition during this golden period is lasting and irreversible, with effects beyond physical health to affect the child's cognitive development. 
    This prompted The Times of India and Nestle to jointly launch an initiative to promote healthy nutrition in the crucial first 1,000 days. 
    The nutrition available in the first 1,000-day period also predisposes children to chronic disease in adulthood. India at present suffers from the vicious cycle of malnourished pregnant women who most often give birth to underweight children. Of the 2.6-crore births in India annually, 23% babies are low weight (below 2.5 kg). Infant deaths and illnesses increase sharply as birth weight declines. Many of these children who survive become stunted or wasted by the time they are five. 
    Pediatrician Meharban Singh says stunted children have smaller head size, impaired neuromotor coordination, sub-optimal learning skills and mental capabilities. Stunted children have around 11 points lower IQ compared to normal children. Maternal and child health expert professor Zulfikar Bhutta from the Aga Khan University Hospital, Karachi told TOI that low birth weight among Indian children is mainly due to the effects of malnutrition during the 1,000-day period. "Consequences of malnutrition are permanent and often passed down from mother to child. Steady decline has been noted in maternal and child mortality in India. Prevalence of severe nutritional deficiencies has also dipped but the pace has been slow. This is mainly because enough importance has not been accorded to the first two years of a child's life that are critical," professor Bhutta said. Experts even add that the seed of chronic illnesses such as diabetes, heart disease, schizophrenia and obesity are laid in the womb itself. 
    Dr Swaroop Sampat Raval, chief of the Early Childhood Association says during pregnancy, the foetus is solely dependent on maternal intake and nutritional stores, mostly fat, for its energy. "Poor maternal nutrition during pregnancy in turn implies a risk of poor nutritional availability to the fetus. Diet intake of a pregnant woman should look at being healthy overall rather than high calorie intake," Dr Raval said. 
    Experts say the last three months of pregnancy and first three years of post-natal life are most crucial for a child's brain development. The size of a baby's brain at birth is almost 70% of the adult size but his body weight is only 5% of an adult. During the first year of life, 15% brain growth occurs. The remaining 10% of brain growth occurs during preschool years. 
    Dr Sanjeev Ganguly, an expert on pediatric nutrition said "what a mother eats decides how the genes of the child will express itself. Culturally in India, a woman eats last, even when she is pregnant. A socio cultural change therefore needs to come about which recognizes that a pregnant woman needs the maximum amount of nutrition. Its not about how much she eats as it is about the quality of food she consumes. Pregnant Indian women are concerned about calorie intake rather that protein intake which is essential for an unborn child." 
    Proper intake of folic acid and vitamin B12 during this crucial 1,000 days by mothers can ensure the overall growth and well being of the child, added Prof. Kalhan. 
    Professor Jatinder Bhati, paediatrician at Medical College of Georgia School of Graduate Studies says underweight childhood, micronutrient deficiencies and poor breastfeeding combined cause 7% of deaths and 10% of the global disease burden.