first 1000 days Archives

During the first week of April each year, the American Public Health Association (APHA) brings together communities to observe National Public Health Week. This year’s theme is Centering and Celebrating Cultures in Health and highlights the importance of fostering cultural connections to health and quality of life.

Last month, we celebrated National Nutrition Month, an annual campaign by the Academy of Nutrition and Dietetics which highlights the importance of making informed food choices across the lifespan.

A beautiful example of the convergence of these two themes is work being done by the Asian Pacific Islander Breastfeeding Task Force (APIBTF) a part of Breastfeed LA, tailoring the Dietary Guidelines for infants and toddlers for Chinese and Vietnamese communities. This project augments APIBTF’s sister organization Alameda County’s Asian, Southeast Asian, Pacific Islander (ASAP!) Breastfeeding Taskforce’s Continuity of Care (CoC) Blueprint Project Prenatal Toolkit for AANHPI families. The prenatal toolkit was adapted from an existing toolkit in Alameda County, and is available in English, traditional Chinese, and Vietnamese.

The initiative is supported by the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity (CDC/DNPAO). NACCHO selected seven communities to strengthen community lactation support through the implementation of the Continuity of Care in Breastfeeding Support: A Blueprint for Communities from November 2022 to July 2023. The purpose of this project is to support the implementation of CoC strategies by local-level organizations among oppressed communities with historically low rates of chest/breastfeeding. [https://www.naccho.org/programs/community-health/maternal-child-adolescent-health/breastfeeding-support#early-childhood-nutrition]

The dietary resources which include an Educational Handout from Dietary Guidelines, Nutrition Resource Directory, and social media posts can be found here, available in English, Chinese and Vietnamese. The materials include a dietary guidelines hand out with two toddler-friendly recipes (with a fun suggestion to use green onion to decorate steamed eggs), three social media messages with a timeline for infant feeding, human milk recommendations, and complementary food recommendations, all commonly eaten in Asian communities. The deliverables are full of color and easy to navigate.

Judy Li and Cindy Young presented their work during NACCHO’s The First 1,000 Days Nutrition: Improving Nutrition Security for Infants and Toddlers in Communities of Color where the Improving Infant and Young Child Nutrition during the first 1,000 days in Communities of Color summary report was introduced.

Li, Young and their team’s work was community-informed, standing by the sentiment, “Nothing about us, without us.” The team spoke with community members about eating habits and learned that families do not eat according to the MyPlate graphic. Instead, they enjoy their meals in family-style servings from bowls. Recipes developed were tested by community members with children and tailored according to their suggestions; for example, the addition of different dipping sauces.

Participants also offered feedback stating that they appreciated the accessibility of the ingredients.

Helpful links

ASAP!’s Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Social Media Toolkit

National Public Health Week’s shareables and toolkit (available in Spanish)

USDA’s Dietary Guidelines for Americans (2020-2025)

The Association of State Public Health Nutritionists (ASPHN) brief on Transition Feeding

Public Health Nutrition Deserves More Attention

Undernourished and Overlooked

Tomorrow is Diwali, a five-day festival that celebrates the victory of light over darkness.

The Foundation for Mother & Child Health (FMCH) India reported that almost eight lakh (hundred thousand) children in India are not able to celebrate their first Diwali due to poor nutrition and health outcomes.

FMCH works to empower families from vulnerable communities with actionable information and services, resulting in health seeking behavior and nutritious food choices in order to tackle maternal child malnutrition, ultimately breaking the cycle of poverty.

“FMCH India’s work empowers women – it gives confidence and encouragement to an FMCH field officer, adds to the skills and knowledge of a government frontline worker, and builds agency and support for mothers in the community,” Shruthi Iyer, CEO and Co-founder, FMCH India tells Our Milky Way.

When Our Milky Way first interviewed FMCH in 2018, the organization had reached 10,000 women and children in Mumbai and Thane districts of Maharashtra. To date, FMCH has now worked with 60,000 families across low income neighborhoods of Mumbai.

Still, in 2020, more than 40 percent of children in India were undernourished and 50 percent of women were anemic.

Community engagement event
Photo credit: FMCH

Within the first 1,000 Days, FMCH strives to implement education sessions in the community, home based counseling, and the strengthening of systems, each strategy with a strong emphasis on monitoring and maintenance of quality. Sustainability has been built into the program through community engagement and government systems.

Because malnutrition and maternal health are complex forces, FMCH engages in a variety of programs. Read in detail about them here.

For instance, as part of Project Poshan, the organization identified that in Mumbai, “only 53 percent of newborns are breastfed within one hour of birth, displaying a serious lack of early initiation of breastfeeding. On the other hand, the percentage of breastfed children aged 6 to 23 months receiving an adequate diet is as low as 6.4 percent in the city.” [ Retrieved from https://www.fmch-india.org/wp-content/uploads/2021/10/FMCH-Annual-Report-2021-Interactive.pdf]

Most recently, in the last year, FMCH “worked with close to 25,000 families, and recorded an increase in early initiation of breastfeeding – 74% from 59%… The national average is 57%,” documented in the latest Annual Report. What’s more, 70 percent of mothers started complementary feeding at the appropriate age of six months.

Their work supporting healthy infant feeding recognizes that breastfeeding is not only the responsibility of the mother though and aims to educate the network of people around the breastfeeding dyad.

FMCH’s most recent annual report describes the success stories of health care providers and the families they serve. Explore them here.

Iyer says the way forward is to establish more direct interventions, build out indicators for their theory of change and to conduct more trainings for Anganwadi workers. (Anganwadis are rural child care centers started by the Indian government as part of the Integrated Child Development Services program.)

In the earliest Indian literature, the Vedas (a large body of religious texts originating in ancient India) recognize the life-giving powers of breastmilk.

As documented in The Religious and Cultural Bases for Breastfeeding Practices Among the Hindus “…Milk and breast are symbolic of longevity and nectarine sweetness” and “‘Drinking of the milk, whose sap is the sap of immortal life divine, may your baby gain long life, as do the gods by feeding on the beverage of immortality!’ (Susruta, III, 10).”

Extolling breastmilk in modern India and globally, through programs like FMCH, is like the light over darkness during Diwali, the FMCH vision achieved: “Healthy mothers and thriving children for a world of unlimited possibilities.”

Tag: first 1000 days

Foundation for Mother & Child Health (FMCH) India tackles maternal child malnutrition by empowering women

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