1000 critical days
“Many things in life can wait. The child cannot. Now is the time his bones are formed, his mind developed. To him we cannot say tomorrow, his name is today.”
The first 1000 days of a baby’s life are critical. It refers to the period that begins with pregnancy planning and goes on till the child reaches his/her second birthday.
Humans are unique. The human brain sets us apart from other living species. To build lifelong health, intelligence, mental development and for physical growth the first 1000 days are critical. Much of this development starts before the baby is even born. An expectant mother’s nutrition plays a critical role in the development of mental, physical and emotional growth of the baby in the womb.
Plan your pregnancy – ensure it’s by choice
The pre-pregnancy/planning phase is as important as pregnancy and childbirth itself. Everything consumed or inhaled while pregnant will be passed through to the foetus. Hence, healthy diet and lifestyle plays a critical role.
Preconception goals:
- Include regular physical activity with healthy lifestyle
- Avoid alcohol and tobacco consumption
- Metabolic conditions like diabetes and hypertension to be controlled
- Getting all the immunizations required
- Screen, treat and prevent infections
- Maintain a healthy body weight
- Healthy balanced diet with essential macro and micro nutrients
- Supplementation as per the requirement
Pregnancy goals
- Healthy Foods: Think for two – but don’t eat for two
The requirement of nutrients differs from person to person during pregnancy. Extra attention should be paid in providing all the essential macro and micronutrients.
- Stay Active
To reach a healthy weight, women should stay active. Working at home or a job is not exercise. Plan a set time for physical activity like walking, yoga
- Supplements
To prevent certain birth defects, supplements like folic acid play a critical role. Start the supplementation as per the recommendation
4. Avoid harmful chemicals and toxins
Certain substances like chemicals, metals or materials can be toxic and harm our health. Limit exposure to toxic substances, for example pesticides on fruits/vegetables, home cleaning products etc. Minute amount of these toxic substances can cause harm during pregnancy.
Attention!
- Quit smoking and avoid people who smoke
- Stay away from pesticides or foods – use organic
- Soak fruits and vegetables in salt water, rinse well before consumption
- Use of soap and water for mopping the floor instead of chemical based cleaning agents
- Food can be stored/eat in glass or stainless steel containers instead of plastic
- Heavy metal like exposure to lead can harm the brain development of the baby. Avoid products that may contain lead such as paints, cosmetics etc
- Mosquito coils in closed room to be avoided, Mosquito nets can be used as an alternative
5. Protect from Infections
Washing hands frequently with soap and water before eating/cooking
Toilet hygiene
Avoid contact with sick people
6. Vaccination
Prevention is better than cure. Hence best defence from certain diseases is vaccination. Consult your health care professional
7. Consultation with Health care professional
Routine clinical examination/Screening (HIV) and check-ups are crucial to prevent the occurrence or control if its pre-existing (Diabetes, Blood pressure etc)
8. No to Alcohol/Tobacco
Smoking, drinking using drugs can cause serious health problems to the baby. Ensure that a healthy lifestyle is adapted
9. Oral health
Brushing teeth twice a day helps to improve oral health, consult your doctor. Pregnant women with gum and teeth (periodontal) disease may have a higher risk of delivering a preterm or low birth weight baby.
10. Emotional Health
Creating a positive and a safe home environment can reduce the risk of baby to develop problems during birth or later in life.
Nutrition Before, During and After Pregnancy
A healthy start for the baby is very important. Rather that eating just to satisfy hunger eat to satisfy special needs.
Mothers and mothers-to-be should ensure correct nutrition as it has a long-lasting impact on health during and beyond the first 1000 days of a baby’s life
While planning the diet it’s important to consider that preconception, during pregnancy and breastfeeding/lactation period as well because baby’s physical growth and mental development depends on the mother’s nutrition status.
Nutrients during Pregnancy
Iodine:
The daily iodine requirement is 220 micrograms. Mild deficiency of Iodine during pregnancy and lactation affects the brain of the unborn child and growing infant, particularly reducing the intelligent quotient (IQ)
The loss of iodine during cooking may range from 7% to 70%. It depends upon the type of cooking method and cooking time. Maximum loss is during pressure cooking and boiling and less in deep frying.
The daily requirement of folic acid is 400 micrograms. Studies indicate that consuming folic acid rich foods prior conception (3 months) and during the 1st trimester protects the baby from birth defects involving the brain and spinal cord.
Iron:
An important micro nutrient – a mild deficiency has a negative impact on the child’s mental development. Iron supplements can improve the child’s mental development, even if the mother continues to have iron deficiency.
Vitamin B12:
The daily requirement of vitamin B12 is 1.2 micrograms. Strict vegetarian mothers are found to have B12 deficiency, which may lead to increased risk of birth defects including in the brain and spinal cord.
Vitamin D:
The daily requirement of vitamin D is 400 IU. Deficiency occurs in women who are not exposed to sufficient sunlight or do not eat food containing vitamin D. deficiency can affect the foetal bone development.
Omega 3:
Omega 3 deficiency has an impact on the child’s brain and vision development. Mustard, rice bran oil and groundnut oil, used as a cooking medium, gives you this kind of fat. Flax seeds and fish are also good sources of omega 3
Eat a variety of foods with various essential nutrients so that your child will also adopt them later and not turn into a picky eater. Scientists at Monell Chemical Senses Center, Philadelphia, found that babies preferred foods which their mother consumed during pregnancy and while breastfeeding. They were more enthusiastic about adopting the same diet. This ensures that your child stays healthy during all stages of development.
STAY HYDRATED
Dehydration can cause contractions; water helps in carrying nutrients to the baby. Water is used in amniotic sac and prevents urinary tract infection
EXERCISE
Adequate nutrition, with enough rest and exercise help in staying healthy during pregnancy. Simple exercises, such as walking, is highly beneficial. It helps improve heart function, reduces bloating, constipation and risk of gestational diabetes and hypertension. It helps mother prevent pelvic and back pain.
Consult your health care professional for exercise regimen.
SLEEP
Women should get into the habit of sleeping on their side, this makes it easy for the heart to circulate blood. The most comfortable position for the mother is lying on the side with knees slightly bent.
PREGNANCY: The next 9 months and beyond
Consult your health care provider to ensure your wellbeing. A missed period is often a sign of pregnancy. A pregnancy is divided into 3 trimesters. Each trimester is 3 months composed of 4-5 weeks. Pregnancy can last for 40 weeks which is about 9 months.
First Trimester: (LMP to 13 weeks) LMP- Last Menstrual period
The fastest growth and development of the baby takes place during this period. The baby’s body structure and organ systems begin to develop. The baby depends on the mother for everything.
Second Trimester: (14 to 27 weeks)
The mother starts feeling the baby’s movements (20th week) and is often called the “golden period”. Baby’s brain develops further and continues till two or more years after birth.
Third Trimester: (28 to 40 weeks)
This is the final stage where maximum weight, height and head circumference of the baby is formed. More than 50% of the cortical brain development happens between 37-39 weeks. The baby continues to develop, gain weight and begin to prepare for the birthing process. The closer to full term or 40 weeks the baby is better to cope with birth and life outside the mother’s body.
Month 1:
By the end of the first month, the baby’s organs begin to form, including the brain, spinal cord, lungs and heart begins to beat. Bones begin to form.
Concerns: Nausea and vomiting; Spotting
- Consult your health care professional for pregnancy confirmation.
- Check the body weight, blood pressure and pulse. Check for any swelling or jaundice recorded at the clinic
- Take supplements like folic acid as per the prescription
- Get the first dose of tetanus toxoid
- Test for urine sugar, protein and pus cells
- Screen for Haemoglobin, blood group, syphilis, HIV, Hepatitis B, Thyroid, Malaria, Thalassemia and sickle cell anaemia
- Glucose tolerance test to be done. If blood sugar is more than 140 mg after 2 hrs of having 75 g of glucose in 300 ml water, consult the doctor immediately.
Month 2:
The baby’s brain, liver, kidneys, bloodstream, and digestive system are developing. The arms and legs begin to grow. Your baby’s face is also developing. Touch is the first of the senses to develop.
- Get the second dose of Tetanus toxoid vaccine
- Exercise regularly. Walking is good.
- Maintain personal hygiene
- Consume fresh, clean and hygienically prepared food.
- Foods rich in calcium and vitamin D (milk, curd, paneer) should be the part of the diet
- Avoid psychological stress, as it may have an impact on the baby.
- Consult your health care professional as per the schedule/plan
Month 3:
Formation of nose, outer ears and facial features are formed along with the internal organs. Baby begins to move.
- Let the employer know about the pregnancy.
- Discuss with health care professional if any work related danger
Month 4:
Baby can smile and frown. Finger nails and hair grow.
Concerns: Constipation
- Get the second dose of tetanus vaccine, if not received
- Continue the supplements along with calcium and vitamin D3 (as per the prescription)
- Consult health care professional for 2nd ante-natal check-up
Month 5:
The baby can now kick, twist and turn. Baby has its own fingerprints and footprints. Brain and nervous system is developed enough to reach towards light and sound.
- Get an ultrasonography done between 18-19 weeks as per the recommendation
Month 6:
Baby develops a pattern of sleep and activity. They can now hear the mother’s voice and music. Eyes are open. Mothers can feel when high up in the abdomen or low down in pelvis.
Eat a nutritionally balanced meal
Check for glucose tolerance. If it was negative initially, repeat it between 24- 28 weeks (as per the recommendation)
Month 7:
Talking, singing and connecting with the baby helps the baby’s brain to develop. Baby feels protected within the womb.
Concerns: Swelling in feet and ankles
- Consult health care professional for 3rd ante-natal check up
- Supplements as per the prescription to be continued
Month 8:
This period is when the mothers body is getting ready for the baby’s birth. Most babies settle in an upside-down position ready for birth.
Concerns: Heartburn or acidity
- Start observing the baby’s movements. If there is a reduction in the movements, consult the doctor
Month 9:
Baby is going to be here soon!!! Breasts may leak yellowish fluid or colostrum. Baby continues to grow and prepares to be born, moving down into the pelvis.
- Consult health care professional for 4th ante-natal check up
- Get blood and urine parameters checked as per the recommendation
THE BABY IS BORN
The birth of a baby is the greatest gift you will ever receive. After a long wait of 9 months, the moment you hold this miracle of life in your arms, your world becomes broader and richer.
Life doesn’t come with a manual. It comes with a mother
Any mother, animal or human, nurtures, teaches and protects her young one to survive in this world. One of the most unique things about a human child and mother is how the brain develops.
Interestingly , the brain is the only organ not fully developed at birth.90% of critical brain development occurs in the first 1000 days.
The first years last forever, the brain grows and develops significantly and patterns of thinking and responding are established. A baby’s brain is twice active an adult’s brain during the first 3 years of his/her baby.
Human child
Brain development has started in the womb, from the formation of the structure, wiring between the brain cells and it goes on …. Until the age of 2yrs after the birth of the baby. Hence 2 years of life is crucial for the wiring of this brain which shapes them as adults.
Brain
It is said that “The genes are the bricks & mortar to build a brain. The environment we provide, as parents, is the architect”. We should try to give the right environment for developing the brain.
Parents should not miss the opportunity because a baby brain is underdeveloped (only 25%) at birth and most of the development takes place in the next 2 years (75%)
The head circumference accurately reflects brain size and growth during the first years of life–the period of the majority of brain growth–except in unusual situations.
- The average new-born’s head circumference measures about 33-34 cm
- Birth – 3 months: an increase of 1.5 -2 cm per month
- 3 to 6 months: an increase of 1 cm per month
- 6 to 12 months: an increase of 0.5 cm per month
- In the first 12 months: Total 10-11 cm gain
- In the next 12 months: 2.3 cm gain per year
In the first two years, babies make 700 new connections every second!
First hour, first day
The GOLDEN HOUR of baby’s life is the first hour after birth
Baby’s respond when they interact with the mother, holding and looking at the baby is important, as baby’s are usually alert and responsive during this time
The relationship between parent and child is through BONDING, it is in the first exchange of eye contact, sound, touch between the mother and the child. It triggers the wires in the brain leading to relaxation and development of intelligence in the child.
Feeding the Baby
The first vaccine for the child is the COLOSTRUM milk
Feeding the baby from the first hour of birth till 6 months is very crucial.
Nursing the baby within the half an hour of delivery, is extremely useful:
Breast feeding benefits the mother by causing the uterus to contract and reduces the amount of uterine bleeding.
The first hour is best to start breastfeeding as the baby is awake and alert. Soon the baby will go into a deep sleep and then it may become difficult to start breastfeeding.
For the first two to five days after delivery, the body produces colostrum, a thin yellow fluid that contains protein and antibodies to protect your child from infection.
Immunization
The first day injections the baby will be given are Vitamin K1, BCG, Hepatitis B and Oral polio. Vitamin K1 vaccine is given within one hour of birth to prevent rare bleeding disorders in new-borns which can cause serious problems.
Srilakshmi H A
(Senior Nutritionist)
The MILESTONES:
“If you want your children to be intelligent, read them fairy tales. If you want them to be more intelligent, read them more fairy tales.” – Albert Einstein