1,000 Golden Days for the Development of the Egyptian Family

This summer, while health advocates across the globe celebrated World Breastfeeding Week and the U.S. celebrated National Breastfeeding Month, Egypt commemorated the launch of their initiative “1,000 Golden Days for the Development of the Egyptian Family.” This work is situated under the umbrella project 100-Million Healthy Lives Presidential Initiative. 

In collaboration with Egyptian Members Association (EMA) of the Royal College of Paediatrics and Child Health (RCPCH), the comprehensive 1,000 Golden Days project provides free-of- charge access to competent midwifery care,  “develop[s] family and parental awareness” and employs medical and psychological examinations for the parent and child within the first 1,000 days (spanning from conception through the second year).

Dr. Abla Al-Alfi presented an honorary plaque to Dr. Khaled Abdul Ghaffar, Minister of Health and Population, in recognition of his efforts in supporting the initiative. Photo courtesy of Kajsa Brimdyr. 

The initiative ensures the “right of the child to be raised in a sound family environment and the right of the mother [and father] to enjoy a healthy life,” as stated by Dr. Khaled Abdul Ghaffar, Minister of Health and Population, during a commemoration speech over the summer.

Healthy Children Project extols the achievements of their long-time partner Dr. Abla Al-Alfi and colleagues.  

Dr. Abla explains that 85 percent of children’s physical, mental and psychological capabilities develop within the first 1,000 days; when proper development isn’t nurtured, the lasting health impacts and challenges often become insurmountable and irreversible.

Healthy Children Project and Egyptian colleagues
Back row: Dr. Kajsa Brimdyr, Dr. Anna Blair, Dr. Karin Cadwell, Barbara O’Connor, Cindy Turner-Maffei, Dr. Amal El Taweel, Dr. Abla Alalfy
Front row: Amira Saber el Sayed, Dr. Farida Mahgoub, Mohamed Akkad

In 2019, Egypt ranked 123rd of 182 countries on the Human Development Index. [ World Bank Group. Nutrition at a Glance: Egypt [Internet]. [cited 2019 Mar 21]. Available from: http://siteresources.worldbank.org/NUTRITION/Resources/281846-1271963823772/Egypt.pdf].

“Although Egypt has made significant progress in reducing infant and child mortality, the World Bank Group reports that Egypt was expected to lose US$1.3 billion to chronic disease by 2015, with more than US$800 million lost in GDP each year due to vitamin and mineral deficiencies,” as noted by Turner-Maffei and Cadwell

Read more about the startling and unacceptable health outcomes in their 2019 coverage here

Targeting these shortcomings, the 1,000 Golden Days initiative specifically aims to support healthy pregnancies including ideal conception spacing, decrease c-section rates, implement skin-to-skin in the first hours and establish exclusive breastfeeding and responsive feeding practices including cue-based feeding, support continued breastfeeding through six months, with the addition of adequate, timely, safe and appropriate complementary foods at six months, and continued breastfeeding through at least two years, as laid out here.  

The experimental phase of the project began in July 2022 in three provinces. The first phase of the initiative will be carried out in ten provinces through June 2024, extending to December 2025 during the second phase, serving 17 governorates.

Breastfeeding is eco-friendly.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is eco-friendly.

Planetary protection has never been more crucial, and the undeniable relationship between planetary health and human health has never been more evident.

In November 2022, world leaders, policy-makers and delegates from nearly 200 countries attended the COP27 UN climate summit, held in Sharm El-Sheikh, Egypt.

Fabrication of Bodies Joined by a Molecule of Air(2022), by Invisible Flock and Jon Bausor, manufactured by MDM Props Limited in Lebanon, represented by Architect & Engineer Karim Attoui. ©Courtesy of Invisible Flock. https://invisibleflock.com/portfolio/bodies-joined/

Presenters made poignant remarks about the climate crisis we find ourselves in.

“We are on a highway to climate hell with our foot on the accelerator,” António Guterres, Secretary-General of the United Nations said.

Sherry Rehman, Minister of Climate Change, Pakistan argued that  “The dystopia has already come to our doorstep …”

Mark Brown, Prime Minister of the Cook Islands, shared, “Our survival is being held to ransom at the cost of profit and an unwillingness to act despite the ability to do so.”

On Decarbonization Day of the summit, Dr. Abla Al Alfy convened a panel of speakers who presented on the importance of the 1,000 Golden Days and the relationship between the climate crisis and mother baby health. [You can access the United Nations Egypt’s recording here which starts at 19 minutes in.]

Dr. Nevein Dous, UNICEF health specialist, covered infant mortality rates, micronutrient deficiencies, mental health challenges, among other global health challenges and called for the integration of services rather than siloing health strategies.


Frederika Meijer with UNFPA Egypt highlighted UNFPA’s work confronting medical violence and reducing the country’s cesarean section rate which soars over 60 percent.

Meijer brought light to the need to create resilient health systems that will withstand the inevitable shocks of the climate crisis.  She noted the important role skilled midwives play in the reduction of unnecessary c-sections, giving way to the work of Dr. Kawther Mahmoud, President of the Nurses Syndicate, Assistant Undersecretary for Nursing and head of the Central Department for Nursing in Egypt, who helps lead the national plan for the midwife.

Many presenters emphasized the importance of family planning counseling and the environmental and health implications of pregnancy spacing.

Dr. Naeema Al-Gasseer’s remarks drew attention to a recent WHO report which states that “Almost the entire global population (99%) breathes air that exceeds WHO air quality limits, and threatens their health.”

Dr. Camilla Kingdon, President of the Royal College of Pediatrics and Child Health, further described that 26 percent of child deaths under 5 years of age have an element of environmental cause like heat waves, water scarcity, vector-borne diseases and flooding. UNICEF has identified that air pollution will be the leading cause of death for children by 2050, she shared. Additionally, there is a clear link between air pollution and miscarriage. Dr. Kingdon went on to describe the prevalence of visible air pollution particles on the placenta.


In connection to these harrowing accounts, Healthy Children Project’s Dr. Karin Cadwell presented research on the environmental impact of powdered baby formula milks in North America. Read about that work here.

Healthy Children Project’s Dr. Kajsa Brimdyr acknowledged the mess we are in and noted how many solutions that may contribute to planetary and population health are expensive and complex. Skin-to-skin contact (SSC) in the first hour after birth though, is simple and easy, inexpensive, is appropriate for all dyads, and touts priceless benefits.

Brimdyr noted just some of the benefits: SSC in the first hour after birth decreases infant mortality by 25 percent in low birth weight (LBW) infants, decreases transfers to the NICU,  decreases maternal stress and depression, improves paternal parental stress, and allows baby to self attach to the breast improving maternal confidence in breastfeeding and increasing breastfeeding rates overall.

The effects of SSC in the first hour extend far beyond the first hours, the first days and first weeks of life. Feldman et al. (2014) followed mothers and their premature infants who had been in SSC and control groups for 10 years. They found that children who had been in the SSC group had better cognitive development, better autonomic nervous system functioning, and mother–child interactions were more reciprocal 10 years later.

Photo credit: United States Breastfeeding Committee

Silke Mader of the European Foundation for the Care of Newborn Infants (EFCNI) and her colleagues are fighting for SSC and breastfeeding support for all dyads. Mader calls for a zero separation policy which is supported by evidence even in the context of the pandemic, she reported. Mader added that fathers and partners are not second-class citizens and should be included in the policies that help shape proper parent infant bonding.

As the climate emergency becomes more and more bleak, breastfeeding is a safeguard for infant and young child health. Read our coverage on infant and young child feeding in emergencies (IYCF-E)  in Prioritizing infant and young child feeding in emergencies during National Preparedness Month and beyond and National Preparedness Month: the U.S.’s deficit in Infant and Young Child Feeding preparedness during emergencies.

COP27 held the first-ever Youth-led Climate Forum ensuring that young people have a place in the conversation about the climate crisis. More on that here.


More resources to explore  

RCPCH Climate Change Working Group

Baby Milk Action’s coverage on COP27

Breastfeeding can help tackle climate crisis but it’s on governments, not mums to save the world

The climate crisis is a health crisis short video



As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us: Where have you seen predatory marketing of breastmilk substitutes?

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.