Early moments matter…

“Someone is sitting in the shade today because someone planted a tree a long time ago”…. Warren Buffet

These are the pearls of wisdom which came to my mind when I came across the UNICEF campaign “ Early moments matter” which kicked off in January 2107.The campaign aims to highlight the importance of first 1000 days in life of a newborn  i.e. from first day of pregnancy to about 2 years of age when all  organs and tissues of the body are being formed and educated to perform their respective functions. Indeed, it is now recognized that individual development is determined not only by genetics, but through a complex interplay of genes and the environment. It has been estimated that at most 20% of lifelong health can be explained by inherited genes. This means that at least 80% of disease risk in later life is due to the environment, including nutrition and life style.

During this critical window of opportunity, brain cells can make up to 1,000 new connections every second – a once-in-a-lifetime speed. These connections contribute to children’s brain function and learning, and lay the foundation for their future health and happiness. A lack of nurturing care – which includes adequate nutrition, stimulation, love and protection from stress and violence – can impede the development of these critical connections. Investment in early childhood is one of the most cost effective ways of increasing the ability of all children to reach their full potential – increasing their ability to learn in school and, later, their earning capacity as adults. This is especially significant for children growing up in poverty. One 20-year study showed that disadvantaged children who participated in quality early childhood development programmes as toddlers went on to earn up to 25 per cent more as adults than their peers who did not receive the same support.

So the question now is how can you make the most of these “ early moments for your child”. I have tried to divide this period into 4 groups :

PREGNANCY(-9 to 0 months):

During pregnancy and ideally starting even before conception the women should eat a healthy and balanced diet to nourish the fetus and to build optimal stores as well. Key nutrients for pregnant women are vitamins D, B2, B6, B12 and choline and the minerals iron, iodine, folic acid and calcium  Furthermore, the quality of fat (i.e. DHA) of the mother’s diet has been associated with positive developmental outcomes. Other than nutrition the mothers mental and social health also has a bearing on the baby and hence all efforts should be to provide most congenial environment. Activities like Yoga, meditation and special antenatal classes go a long way in allaying maternal fears and anxieties and provide her social security in form of a peer group.We all have heard Abhimanyu’s story in our mythology so the importance of antenatal period can very well be fathomed.

BREASTFEEDING(0 to 6 months):

WHO recommends exclusive breastfeeding for first 6 months which should be continued till 2 years of age with gradual introduction semisolid and then solid foods. Besides nutrition the care from the family as whole and not just the mother is what is warranted. It goes without saying that standards of hygiene and cleanliness, love and care various visual and auditory stimuli go a long way in shaping child’s future as this is the time when baby is first exposed to new sounds and sights. Talking with your baby and making eye contact is beneficial in forging a bond between mother and baby and also provide valuable stimuli to the growing brain. Cuddling and holding the baby make baby feel cared for and secure and should be encouraged. Mother being the primary care provider in our setup should be provided with physical, social and mental support and care so that she not only recovers from the hardships of child birth but truly becomes capable of being a MOTHER from being just a women. Safety of the environment is another important aspect. Never shake your baby, prevent exposure to second hand smoke, don’t leave your baby in supine position when unsupervised Place your baby in a rear-facing car seat in the back seat while he is riding in a car and. Vaccination shots are an important aspect of this time period as not only they provide protection against some sinister but preventable diseases but also give an opportunity for assessment and interaction with a pediatrician who not only provide cure to ailments but has an equally important role in monitoring growth and development of the baby and to timely identify timely the so called “red flags”. Your relationship with your pediatrician should be that of a friend and a guide who is there to help you.

6-12 months( introduction of solids, sitting, crawling etc):

Weaning is an important issue at this stage as milk no longer suffices their nutritional requirement. From the beginning of weaning, children face a key energetic and nutritional gap as they undergo a rapid period of growth, functional maturation and eating behavioral development so nutrition during this phase of life is therefore doing much more than simply ‘providing energy’. So it is important to choose right kind of foods and in right form, consistency and quantity as they determine their long term food habits, growth and maturation of bodily functions. Motor and language development are important aspects of this age. The baby slowly gains control over posture and progresses from sitting with support to creeping, crawling and standing. This is possible because of interaction between developing brain and muscles and new synapses being formed, motor memories being made. Providing a safe environment when the baby starts moving is essential. Reading, singing and talking to baby help in language development. Use of bright picture books and repeating names of things is something which helps is rightful stimulation of the infants brain.

1 to 2 years:

During toddlerhood, from 1 year of age and beyond, children continue to develop rapidly and so it is crucial they receive specific and appropriate nutrition to support a progressive transition to the family diet.

Young children have specific nutrient requirements not only to fuel their rapid growth, but also because they metabolize foods and nutrients differently from adults. Toddlers need up to 7 times more of some specific nutrients compared to an adult (per kg body weight), therefore, with every spoon, a child has to eat significantly more (micro)nutrients than an adult – so it is important that a child receives nutrient dense foods as opposed to just energy dense foods

A regular family diet may not always be able to satisfy their nutritional requirements like iron, zinc, vitamin D and essential fatty acids. High levels of protein and salt in adult diets may even pose nutritional challenges for young children. Providing growing-up milks or toddler milks as part of a balanced diet can be an effective food based strategy to address these nutrient imbalances.

Furthermore, toddlerhood is a period of life characterized by a gain of autonomy resulting from the development of motor function skills and a change in the relationship with parents, where the parental feeding styles can have a profound impact on later eating behavior. As children’s brains develop, so do their emotions, which are real and powerful. Children may become frustrated if they are unable to do something or have something they want. They are often frightened of strangers, new situations or the dark. Children whose reactions are laughed at, punished or ignored may grow up shy and unable to express emotions normally. If caregivers are patient and sympathetic when a child expresses strong emotions, the child is more likely to grow up happy, secure and well balanced.

Boys and girls have the same physical, mental, emotional and social needs. Both have the same capacity for learning. Both have the same need for affection, attention and approval. Both parents, as well as other family members, need to be involved in caring and nurturing the growth, learning and development of children. They should make both girls and boys feel equally valued as they encourage them to learn and explore – this is important preparation for school.

The most important message is that all children grow and develop in similar patterns, but each child develops at his or her own pace. Each child has his or her own interests, temperament, style of social interaction and learning. In short each child is unique and hence comparisons if any should be avoided.