Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives

By Cindy Turner-Maffei, MA, ALC, IBCLC

Several of Healthy Children Project’s faculty members were delighted to travel to the Lake District in England to attend and present at the “Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives” conference, held June 10 to 12, 2019. [The location of the conference varies, occurring in the UK on odd years, on another continent on even years. Healthy Children co-sponsored the MAINN conference in 2018 in Deerfield Beach, Fla.]

One of the great joys of this conference, sponsored by the University of Central Lancashire (UCLAN)’s Maternal and Infant Nutrition and Nurture Unit (MAINN), is that participants gather from all over the globe to share insights from research into infant and young child feeding (IYCF). Our team interacted with presenters and participants hailing from countries as diverse as Ghana and Ireland, Nepal and Malaysia, Cambodia and Australia, Bangladesh and Canada.

Over dinner each night we discussed highlights and wrangled with integrating findings from two daily plenary sessions as well as six different concurrent sessions, with five or six tracks each.

Some memorable insights for us:

  • Maintaining evidence-based is a never-ending process requiring not only ongoing uptake of new information, but also ongoing monitoring and evaluation of practice. Renee Flacking’s initial conference plenary focused on the decrease in exclusive breastfeeding that seems to be occurring in Swedish Neonatal Intensive Care Units (NICU), perhaps particularly in those that utilize single family care NICU rooms vs. open-bay NICU units. Dr. Flacking described how in earlier days parents were told that providing human milk was “the only thing” they could do for their babies; today Swedish parents are welcomed to stay in the NICU with their babies, they know firsthand the importance of skin-to-skin contact, responsive parenting, etc.. Renee also discussed how when the parents are in charge of the baby, as in family care, the staff may tend to back off on strong messaging that is perceived as “pressure” to breastfeed. Even in a country where breastfeeding is perceived as normal and breastfeeding support abounds, seemingly positive changes in policy and practice have the potential to create unintended negative side effects.


  • Being reminded by anthropologist Daniel Sellen of the University of Toronto that no country has yet managed to avoid the occurrence of childhood obesity. We learned that 90 percent% of countries experience the double burden of malnutrition,: simultaneously experiencing inadequate food access and obesity. Dr. Sellen emphasized the need for novel approaches to this challenging problem, and talked about the rising use of new technologies to address infant feeding support. See his team’s work on using mobile phone apps in maternal and child health in rural Tanzania here and here. As lactation care providers, we struggle with how to keep the “human touch” in this era of growing tech solutions.


  • Learning about the tenacity and hard work of teams all around the world. For example, Michelle D’Almeida and colleagues at the University of Sydney built a local food intake and recipe calculation tools for cell-phone platforms for the mSAKHI study in India. Indian food composition tables do not include cooked foods. Imagine the complication of calculating how each participating household makes their special curry, starting from quantifying the individual ingredients and how they’re cooked! Without such a sensitive tool, it would be difficult to evaluate the nutrition needs of families, especially infants and young children.


  • Hearing about the hard work going on to support the growth of stunted children in low-resource settings without relying on commercial food products. (For an eye opener about the commercial profit involved in one of the prepared ready-to-use-therapeutic foods, read this or this). Several researchers shared the challenges of trying to help families overcome malnutrition. For example, University of Sydney researcher Bindi Borg presented her team’s work in Cambodia to develop a sustainable supplement using local foods (fish, rice, soy, mung beans, oil and water). Although they did not find the product successful in reversing child malnutrition, they created a locally sourced food that was appealing to both children and their adult caretakers.

  • Coming back to Renee Flacking’s initial presentation, our learning can probably best be described by some of her concluding points:
    • Foster togetherness of families and create supportive environments
    • Acknowledge that design affects communication – be creative in this process!
    • Question routines and policies; think about the evidence
    • Acknowledge emotions—of infants, parents, staff
    • Offer person-centered care;, keep infants and their families in the forefront

For more coverage on the “Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives” conference, read Kajsa Brimdyr’s latest Tweets

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