Nurturing care is critical to improving health outcomes

Photo by Greta Hoffman

A friend recently told me, “I vowed to never use the word ‘diet’ in front of my daughter.” She explained how as she was growing up, her mother was fixated on dieting, and how that affected her relationship with food and her body image. I sympathized. My grandmother was a model, and I grew up in a ballet school, so body image was always at the forefront of my existence. My friend and I discussed the challenge of modeling healthy eating for our kids when we ourselves have been inflicted with such detrimental habits; things like eating in secrecy and restricting calories. 

Our conversation segued, soon chatting about convenience and ultra processed foods, what exactly are healthy choices?, and this incessant feeling of being rushed. We lamented about the after-school pace: hurry-up homework, hurry-up mealtime, hurry-up extra-curriculars, hurry-up bedtime.

Photo by August de Richelieu

The time to model healthy eating and the ability to engage socially over a meal is so condensed, families often forgo the art of dining and sharing meals entirely. Many of us have fallen to “the packet apocalypse”, propped bottles, hurled yogurt tubes to the back of the van, and scarfed- down burgers from the drive-thru.

Checking my email later this day, I was pleased to find Global Health Media’s recent announcement of their Nurturing Care Series.  While the 10-video collection is intended for health workers and not necessarily for direct family use, the resource felt like the perfect reminder of the importance of prioritizing responsive, nurturing and reciprocal interactions in all of our behavior, including meal time. 

Photo by Keira Burton

Global Health Media’s series is in partnership with USAID’s Responsive Care and Early Learning (RCEL) project which focuses on “good health, adequate nutrition, safety and security, responsive caregiving, and opportunities for early learning” as critical components to improving early childhood development (ECD) outcomes. 

“Integrating responsive care and early learning messages into existing nutrition counseling has significant potential to improve both nutrition and ECD outcomes,” the organization’s Advancing Nutrition page states. 

Over the years, Our Milky Way has produced quite a collection highlighting responsive feeding and interactive relationships. Stewed in a bit of irony, as I write to you from the glow of my computer, I’d like to spend this week resurfacing these pieces. 

 

 

 

  • Photo by Luiza Braun

    Mother and bab(ies) attend and respond to one another facilitating nourishment, the flow of hormones, immunity, learning and bonding, comfort, fun, an all-encompassing sensory experience that has generational impacts on social, emotional and physical health. Breastfeeding is collaborative covers the intimacy of the breastfeeding dyad up to breastfeeding as a collaborative global food security system. 

 

 

  • Cindy Turner-Maffei’s coverage of the “Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives” conference… well, it’s really all in the title. 

 

  • Humans are carry mammals, not nest or cache animals. Baby-wearing facilities things like  the development of healthy physiological functions to providing a interactive social interactions for infants and young children, where they are included in the “action” rather than strapped into devices with little stimulation. Babywearing as a public health initiative  highlights Rebecca Morse’s work and further explores the importance of baby wearing.

 

 

  • Finally, we couldn’t close out without noting skin-to-skin, where connections are first fused outside of the womb. Find Our Milky Way’s collection on skin-to-skin and kangaroo mother care here and here

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.