How to feed right in first 1,000 days of life

Diets around cultures in the world, apart from being influenced by environmental factors within regions, are also shaped by beliefs such as how eating a particular thing would develop or diminish a particular strength or ability.

There is no one topic that has as many fads as what people eat, there is such a flood of information on nutrition and so many recommendations in both traditional and social media that most times it can be confusing and even contradictory.

When it comes to feeding newborns, infants and toddlers (growing children), there are so many dos and don’ts from grandparents, parents, communities that it has become almost impossible to know what is real and/or right, increasing the risk of dangerous feeding habits.

A review of leading medical journals like PubMed and Cochrane, emphasise the importance of the right feed and feeding habits for growing children and identified benefits for both the periods of breastfeeding and long afterwards that range from reducing neonatal infections and deaths in infancy to obesity and cardiovascular diseases in adulthood.

First 1000 Days

The first 1000 days of a child’s existence (0 – 2 years), presents a unique window for every child to enjoy a reduced risk of death, healthy growth, and brain development. Debunking myths based on tales passed down from generation to generation with no basis in scientific truth and embracing better breastfeeding habits, are the only way mothers can take advantage of this opportunity on behalf of their children.

Demonstrations have shown that properly taught behaviours can influence positive attitude changes in mothers and communities.

Phases of Transition

When a baby is born, it goes through three phases of transition in feeding which need to be properly guided. Proper initiation of a baby at the commencement of breastfeeding determines a baby’s bonding behaviour and subsequent feeding habits especially within the first six months of his/her life.

Early attachment within the first hour after birth is the first step in achieving this. Babies instinctively move towards and attach themselves to the mother’s breast if left on their own on the mother’s abdomen within this period. This strengthens the bond and stimulates the mother’s milk production.

This first-hour initiation is important because of Colostrum, the first milk produced by a mother’s breast, this milk contains antibodies and white blood cells that helps the baby build a strong immune system, provides a strong coating on the baby’s stomach and intestines to keep germs from causing newborn illness and helps to prevent low blood sugar in newborns. All of these benefits can be missed if babies are not put to the breast within this period.

Milk-let-down

Some mothers experience a delay in milk-let-down after delivery and there is often the temptation to think that the babies would go hungry and hypoglycaemic (low blood sugar). But mothers should not panic at this.

The baby’s suckling in this first hour initiates and stimulates milk production for mothers who experience this delay and depriving both the mother and the baby this crucial act only further delays milk-let-down.

When babies are given other food items within this hour and up to the first three days of life, there is a far greater chance of continuing with these food items as well.

From day 0 up until 6 months of life, the mother’s milk is sufficient in nutrients and quantity for the growing child. However, the increase in demand and adaptation to the baby’s feeding habits and the mother’s circumstances can tend to cause some trouble.

Mothers need to learn to breastfeed in order to have pleasant experiences. Things like positioning could be wrong, baby’s feeding language could be misunderstood, schedule of milk production etc, are some of the challenges with breastfeeding and as such learning the art and act of breastfeeding is important.

When the Mother is Away or Cannot Breastfeed

There are circumstances that could necessitate giving a baby other foods such as when a mother or the baby is sick or when the mother is away especially after maternity leave. However, with more foresight and planning, these circumstances can be overcome.

Expressing milk for a baby while a mother is away can easily solve the problem of mothers being away, and this milk can be kept the whole day without refrigerating. Breastmilk can be refrigerated and preserved for lengthy periods, the Mayo Clinic says freshly squeezed breast milk can be frozen for 12 months.

It is important that the community within which the mother and child live and interact is conducive to breastfeeding. Workplaces, for instance, should provide this needed support.

Circumstances of Ill-health

In other circumstances of ill-health such as infection with the group of human T-cell lymphotropic viruses (type I & II), active Ebola or untreated brucellosis (an infection from animals to man, mostly through unpasteurised milk), breast milk should not be given. But with active infections of tuberculosis, herpes simplex virus breast lesions, influenza (viral airway infection with symptoms similar to malaria) or varicella (chicken pox), babies should not be breastfed directly but should be given expressed breast milk from the mother since this does not contain the infective agent.

With HIV infection, mothers can choose to exclusively breastfeed or not but are strongly advised to adhere strictly to the chosen regimen. In these cases, the doctor’s advice and appropriate individual reviews should strictly be followed.

After Six Months

After six months, a baby’s growth rate increases greatly from this age and the mother’s milk is no longer enough. So other foods should be introduced in addition to breast milk.

This transition has proven to be challenging for most women because the baby is used to breastmilk. Unfortunately, poor acceptance of new foods can lead to frequent illnesses such as diarrhoea for the child if not handled well.

Learning to carefully combine food items from given food groups which must include cereals and tubers (such as rice and potatoes), legumes (i.e foods within the bean family such as soya beans and our common beans), meat and poultry (meat and meat parts such as liver, eggs, etc), fish (especially the little fish), vegetables (such as ugwu, green, waterleaf), oils (palm oil, vegetable oil), and fruits, and providing this in a manner acceptable to the growing child, are the key to a good diet for the baby in this period.

Akamu, Indomie and Bobo?

Giving the baby akamu (pap), indomie, bobo (juice), or tea continuously is not proper dieting for the child. These might be easy and pleasant to the child but it gives them little nutritional value for growth.

Feeding a child properly at this stage would determine how well they move on to eating the family’s diet within the next 8 –12 months. This period is not an opportunity to wean the baby off breast milk, because breastfeeding can and should still be encouraged to continue up until the child’s second birthday!

Support for Mothers

Mothers need a lot of support through all of these stages and this support can come from the healthcare centre or the maternity home where a mother receives antenatal and postnatal care, the husband and grandparents within the home, and community members who share a woman’s daily life.

Nigeria has about 11 million stunted children, and with chronic diseases like obesity, diabetes, and hypertension on the rise in the adult population, this habit of breastfeeding the next generation can turn the trend around.

Families can spend a lot of money on feeding a growing child, but with breastmilk and the right combination of locally sourced foods, after the first six months, money or the lack of it cannot be an excuse for insufficient or wrong infant nutrition.