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Month: March 2018

Guest Post: Perspectives on Breastfeeding from a Clinical Pediatric Dietitian

In honor of National Nutrition Month, 1,000 Days is hosting its annual #Marchis4Nutrition campaign to amplify the critical role the world’s mothers play in nourishing the next generation. All month long, we have been imagining a world in which moms have the support they need to give their children a healthy start to life, highlighting the voices of moms and advocates across the country and around the world. The following guest post was written by Marti Toner, MS, RS, LD.

“Breastfeeding shouldn’t be complicated; women have been doing it since the beginning of time.”

“The pediatrician said that my baby isn’t gaining enough weight, so we are supplementing with formula.”

“My newborn is just a really good sleeper, I’m not going to wake her to nurse.”

“My diet isn’t perfect, so I’m giving my baby formula.”

“I went back to work and do not have time to pump to maintain my supply.”

Working as a clinical pediatric dietitian, I encounter variations of these sentiments on a recurring basis, often when a baby has been admitted due to “failure to thrive”, or poor growth. These comments come not just from mothers – I hear them from fathers, grandmothers, family friends, and even fellow clinicians.

Breastfeeding is hard. It requires work and commitment. Yet, few women in this country have access to supportive services to provide the tools to meet their breastfeeding goals. It has been widely promoted that breastfeeding is the ideal form of nutrition for infants for at least the first 6 months of life – but what if your little one struggles to latch?  What if your milk supply doesn’t come in fully until your newborn is 5 or 6 or 7 days old? Or conversely, what if you develop oversupply?

In each of these scenarios properly trained lactation consultants are able to guide new moms through their struggles. However, once most women leave the hospital or birthing center, they lack access to such expertise (or do not know where to find it). Instead, women across the socioeconomic spectrum are left to navigate these hurdles on their own (and all on very little sleep!). Far too often, women who desire to breastfeed give up due to these obstacles.

I was almost one of those women myself: when my daughter was born two years ago, she initially latched beautifully. But because my milk supply did not come in immediately (it took a full week, in fact), she quickly grew frustrated when she was unable to obtain the nourishment she was seeking. I discharged from the hospital 48 hours post-partum and the situation grew worse at home. Despite my background in nutrition, I struggled to comprehend just what was happening or how to remedy the situation.

The difference in my case, however, is that I have a close friend and colleague who is an International Board Certified Lactation Consultant (IBCLC). She came to my house and worked with us to create a plan for feeding that would encourage my milk supply and teach my daughter how to effectively latch. While it was not an instantaneous victory, within a few weeks (and with a great deal of patience), my daughter was nursing well. Ultimately, she successfully breastfed for 14 months.

So what is the answer? If only it were that simple! Culturally, our country has a long way to go to offer the best environment for all mothers to meet their breastfeeding goals. But, implementing these 3 steps would be a reasonable start:

  1. First, education, education, education. Providing lactation support both prenatally and postnatally – via community programs, in OBGYN and pediatrician offices, and through widely disseminated web-based campaigns – to detail the benefits and portray an accurate depiction of breastfeeding.
  2. Second, all new mothers should have access to skilled clinical lactation care at little or no cost and within a reasonable distance to their home.
  3. Lastly (and this is a big one!), mothers should have the reassurance of job security while on a paid maternity leave. This guarantee would afford them the opportunity to establish and maintain a mutually beneficial breastfeeding relationship with their child.

If we as a nation truly want what is best for our children, we must start by supporting our mothers. We must provide clinical and intellectual resources to allow them to make educated decisions about the best way to nourish their children – and further, how to navigate any challenges that may arise.

Motherhood may often feel like an impossible responsibility – but feeding your child shouldn’t be.

1,000 Days Welcomes 2018 Spending Bill

Last week, Congress passed and the President signed the Consolidated Appropriations Act of 2018, funding the federal government through the end of Fiscal Year 2018. After nearly six months of short-term spending measures, this deal provides funding certainty for many of the critical support programs for moms, babies and their families here in the United States and in developing countries around the world.

Specifically, we were encouraged to see continued funding for the Centers for Disease Control and Prevention’s (CDC) Hospitals Promoting Breastfeeding program, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Maternal and Child Health Block Grant. Additionally, the legislation provides a nearly 4% increase in topline funding for the international affairs budget, which includes vital development programs, while providing continued funding for much-needed global nutrition interventions targeting the first 1,000 days. These programs help ensure that moms, children and their families can get the support they need to grow and thrive.

As Congress turns their attention toward the Fiscal Year 2019 appropriations process, 1,000 Days will continue to fight for increased investments in the evidence-based programs that best serve the nutrition and health care needs of all moms and babies.

We should #Bethegeneration

The 62nd session on the Commission of the Status of Women (CSW) captured the attention of world leaders, advocates and influencers to discuss progress towards gender equality, especially “challenges and opportunities in achieving gender equality and the empowerment of rural women and girls.”

This year at CSW, Global Citizen used the opportunity to kick off its “Be the Generation” campaign at a side event calling for gender equality where I was asked to speak. This will be a year-long campaign inspired by the legacy of great leaders like Nelson Mandela, to challenge global citizens to raise their voices together.

As an advocate for improved nutrition, the campaign really speaks to me, because advocating for nutrition must be more than just a hashtag or a report launch. It is a challenge and a call to action that we will be the generation to see the end of all forms of malnutrition.

This is what compels me to share my story and that of others on a global stage – to make sure that this call to action is heard by decision makers around the world. CSW allowed for me to share these stories.

My own personal struggle with ill health and the difficulty to access specialized health care made what would have been a six-month issue into a three-year-fight.

During this struggle, if you had asked me what future I envisioned for myself, I would have told you my goal was to get out of that hospital so that I could go back to school and eventually get a job. I had exams to write, ambitions to fulfill and a career to pursue.

In 2016 I met a woman named Saliwe, an experience that really put that question into perspective for me. We met while I was on a trip to the Mumbwa district in Zambia to document a World Food Program project improving nutrition. 20-year old Saliwe and her three children relied on this program, particularly the communal garden, to get the food and nutrition they needed.

When Saliwe was asked this question about her future, her response was: “I just want to get through the day.”

Daring to dream is not an option for so many girls. The day-to-day struggle to just survive takes precedence. Women and girls in many parts of the world live in a system that is not designed to help them thrive – or dream. Unfortunately, Saliwe’s story is not unique:

  • More than one billion women and girls do not have access to the adequate nutrition and healthy diets they need to survive and thrive.
  • Adolescents have been largely neglected from the conversation, often missed by health services and faced with unique challenges, particularly in the most rural parts.

Sharing Saliwe’s story is critical to enacting change. Sharing stories of the women and girls most at risk of suffering from malnutrition reminds us to continue to hold our leaders and ourselves accountable.

Only by prioritizing critical actions to address the women and girls who are currently left behind can we accelerate progress towards the SDGs, build political leadership and mobilize new and additional resources that will result in improved policies and necessary progress.

We have set nutrition targets that we all need to work towards. Through SDG2 we have committed to end all forms of malnutrition.

We can be the generation that successfully ends all forms of malnutrition – and investing in women and girls’ nutrition is crucial. But we must start by making sure their stories are heard.

Mwandwe Chileshe is a Global Program Associate at 1,000 Days, a Global Health Corps fellow and Global Citizen Youth Advocate. In her role at 1,000 Days, Mwandwe supports the organization’s efforts to mobilize greater resources for global nutrition by supporting the management of ICAN and participating in international coalitions. She previously led the Zambia Civil Society Scaling up Nutrition Alliance, a network that works to improve the status of nutrition in Zambia.

#Marchis4Nutrition: What if moms had the support they need to ensure their children get a healthy start?

In honor of National Nutrition Month, 1,000 Days is hosting its annual #Marchis4Nutrition campaign to amplify the critical role the world’s mothers play in nourishing the next generation. All month long, we have been imagining a world in which moms have the support they need to give their children a healthy start to life. In this final week of March we’re asking:

What if moms had the support of programs and policies to ensure their children get a healthy start?

Policies and programs that prioritize the health and nutrition of moms and babies can make a huge difference. These societal investments can positively impact the nutritional health of women, infants and toddlers by improving access to healthy foods, increasing a family’s economic security, and improving access to health services.

Estimates show that almost half of the world’s 900 million extremely poor are children. Supportive policies and programs also play an important role in reducing poverty and ensuring that children have the opportunity to thrive.

So, what will it take for moms and their families to have the support they need?

In the United States, for example, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is an essential social safety net program supporting nearly 8 million women, infants and children every month. WIC is a proven effective program that improves birth outcomes, access to healthy food and a child’s development. WIC provides pregnant women, new mothers and their young children support to access whole grains, vegetables and other healthy foods. This, along with nutrition counseling, healthcare referral services and breastfeeding support, helps moms give their kids a healthy start.

 “WIC’s ‘Mom Strong’ centers assure moms healthier babies, toddlers, and young children. At WIC, moms get pre-natal health care referrals and the breastfeeding support they need; babies and young children get pediatric and immunization referrals; parents and grandparents are empowered with nutrition tools and resources to make the healthy choices for their children. With WIC, the whole nation benefits from healthier, happier more productive families.”
-Rev. Douglas A. Greenaway, President & CEO, National WIC Association

Around the world (including in the U.S.) additional social supports are needed to improve the health of moms and their families. Cash transfer programs, for instance, are an important means of improving economic security and access to maternal and child health care for pregnant women and new mothers, particularly for women living in poverty. These programs provide eligible families, often the most impoverished or vulnerable, with income support. Research shows that families with access to programs like cash transfers consume a more diverse and higher quality diet since nutritious food is made more affordable by the transfer.

Paid family leave is another critical policy needed for women and families around the world. Job-protected paid leaves enables women to have the time they need to care for themselves and their newborns following the birth of a child.  There is strong evidence that shows that parental leave can help reduce infant death and illness, increase the likelihood that babies get their pediatric check-ups and immunizations, and lower mothers’ risk of health complications after childbirth. Studies also show that paid leave helps women breastfeed more successfully and for longer periods of time, enabling both mom and baby to reap the powerful long-term health benefits of breastfeeding. In the U.S. alone, if breastfeeding rates improved, over $3.6 billion would be saved in treatment costs for childhood illnesses. Unfortunately, the U.S. remains the only industrialized country in the world without a national paid maternity leave policy.

“If moms had access to social supports, their breastfeeding journeys could continue for longer providing further benefits to them and their children.”
Helen Keller International ARCH Nutrition

ALL moms need support – from accessing nutritious foods to paid family leave – to ensure their children get a healthy start in life. Join the #Marchis4Nutrition conversation on Facebook and Twitter this month and tell us what you think: What does the world look like if moms had the support they needed from programs and policies to ensure their children get a healthy start?

Guest Post: Conquering Nutrition Myths in Myanmar – Supportive Programs #Marchis4Nutrition

In honor of National Nutrition Month in March, 1,000 Days is amplifying the critical role the world’s mothers play in nourishing the next generation through our annual online #Marchis4Nutrition campaign. Throughout the month, we will also be highlighting stories from our partners. Follow along and get involved on Twitter and Facebook with the hashtag #Marchis4Nutrition.

Save the Children believes every child deserves a future. They work in 120 countries around the world to give children a healthy start in life, the opportunity to learn and protection from harm. Save the Children does whatever it takes for children – every day and in times of crisis – transforming their lives and the future we share.

Save the Children works in many communities with mothers such as Aye Zar Zar Soe to provide robust health and nutrition programs that save children’s lives and ensure they grow up healthy.

This is Aye Zar Zar Soe’s story from Myanmar.

My husband and I live with our six children in Shwe Pyi Thar, a township on the north west of Yangon. He is a highway truck conductor and I was a flower vendor before I delivered my youngest child. To make ends meet, my elder children sell flowers such as jasmine, yellow-ginger lily and waxy flower at the local market.

I joined the nutrition knowledge training conducted by Save the Children during my third month of pregnancy. For my elder children, I had no idea about nutrition and followed the suggestions from my relatives. They told me to avoid some specific foods and that I must only eat soup and fried fish. They also said that my baby will have flatulence and diarrhea if I eat vegetables and chilies. I also fed rice to my children before they were 6 months old. My elder children were suffering a lot from malnutrition and were very thin and sick often. At this last child pregnancy, I ate a variety of food. My baby is very healthy and he never needs to goes to the clinic. My cooking style has also changed because I have realized the importance of nutrition to children from the training.

Five years ago, we began to have financial difficulties and gained a debt of 20 lakhs (approx. $1,500 USD). During this time, I couldn’t take care my children and feed them enough breast milk because I spent so much of my time trying to make money outside. Sometimes, we had only one meal for a day.

Thanks to Save the Children, I now get a cash support payment, along with financial literacy and nutrition knowledge training to help me care for my family.

The financial management training conducted by Save the Children changed my life. In the past, I spent as much money I had on unnecessary things. I couldn’t prepare breakfast for my children and instead I gave them money for them to purchase breakfast themselves. After the training, I got the knowledge of how to spend money and differentiate between needs and wants. Now, I prepare breakfast for children and I can save more money.

With financial and technical support from Save the Children, I can make money from my home. They helped me buy two pigs – and once they grow, I will sell them and buy 3 piglets. This is the way of making money from pig raising. It is easy for me because I am not able to make money outside with my toddler.

Eight Years Later, More Families Have the Health Insurance They Critically Need

Eight years ago, the Affordable Care Act became law, making it easier for moms and young children to access high-quality and affordable health insurance. Today, more American families have health insurance whether through their employer, the Health Insurance Marketplace or Medicaid, and their insurance is required to include essential health services—including many that support women and young children.

Just being a woman no longer is a reason for insurers to charge more for equal coverage. Maternity and newborn care, hospitalization and recommended preventative services are all considered essential health benefits, meaning these services must be included in all new insurance plans. And women can no longer be denied coverage for pre-existing conditions such as a previous pregnancy, C-section, diabetes, or cancer. These positive changes to our health insurance system have meant more moms, children, and families have the health security they deserve.

1,000 Days believes that every mom, child and family in America deserves a healthy first 1,000 days. We continue to support guaranteed access to high-quality, affordable health insurance that offers comprehensive benefits for pre-conception and pre-natal care, maternity services, breastfeeding and post-partum supports, pediatric care and other critical maternal, infant and young child health services. In addition, we reject all efforts that would make it more difficult for families to access comprehensive health insurance, result in increased numbers of uninsured people, or allow health plans to put needed services out of reach. Any such effort rolls back the progress we’ve made — and will result in worse health outcomes for moms and children.

Today, we say thank you to the policymakers, health care providers and plans, allies and moms across the country who work every day to protect health care for our moms and babies. We will continue working to keep improving our health care system to prioritize the needs of moms, children and families.

Guest Post: Promoting Healthy Food to Pregnant Women in Guatemala – Access to Nutritious Foods #Marchis4Nutrition

In honor of National Nutrition Month in March, 1,000 Days is amplifying the critical role the world’s mothers play in nourishing the next generation through our annual online #Marchis4Nutrition campaign. Throughout the month, we will also be highlighting stories from our partners. Follow along and get involved on Twitter and Facebook with the hashtag #Marchis4Nutrition.

The National Alliance of Indigenous Women for Reproductive Health (ALIANMISAR) consists of more than 90 organizations and actively participates in citizen monitoring, advocacy, and policy dialogue to promote better, more culturally-appropriate health services that are accessible to the indigenous populations, especially those living in rural areas and in poverty.

Leonor García Quino is a member of ALIANMISAR in Guatemala. This is her story.

My name is Leonor García Quino, I am an indigenous woman, Kiche’ is my mother tongue, I was born in the Municipality of Zacualpa, located at 43 kilometers from the municipal capital Quiché and 206 kilometers from the capital city. At the age of 12, I began to suffer from different diseases. An elderly person of my community told me that I had a “gift” which I should exercise, otherwise, I would never be cured. This is how at this age I began to work as a midwife. I am now forty-nine and have been attending deliveries and providing accompaniment to women in their pregnancy process for 37 years.

Feeding is undoubtedly, a fundamental aspect during pregnancy, as the mother must eat for two. I reaffirmed this, in the trainings received as a member of the National Alliance of Indigenous Women for Health, Nutrition and Education (ALIANMISAR), with the support of USAID/Health and Education Policy Plus (HEP+) project.

I heard once, one of my patients saying that she had not enough resources to feed properly, so I told her about many herbs cultivated in our community, which are very nutritious. For example, the nightshade, which contains a lot of iron and helps prevent anemia; I also mentioned other herbs like, ixbut, bledo, watercress and broccoli, besides other fruits and vegetables, some of which are also produced in our community.

From that experience, I decided to promote the importance of consuming nutritious food among women. I pointed out that they do not need a lot of money, because some of this food is produced in the community and is affordable in terms of price. I also mention that this food is more nutritious and I do not recommend buying soups or sodas in the store.

Recently at home, with the support of my husband, I planted a garden where I have different plants and nutritious herbs. When my patients come to see me, I take the opportunity to talk them about the importance and benefit of consuming nutritious food and I show them my garden. There are also many local students who visit my garden to learn more about the benefit of the herbs and plants that grow in it.

I feel very satisfied with the work I do, because thanks to the information and training I receive in the different activities that I attend, I have been able to support other people, especially pregnant women, to eat properly.

Guest Post: Improving Women’s Diets to Accelerate Progress on the SDGs – Access to Nutritious Foods #Marchis4Nutrition

In honor of National Nutrition Month in March, 1,000 Days is amplifying the critical role the world’s mothers play in nourishing the next generation through our annual online #Marchis4Nutrition campaign. Throughout the month, we will also be highlighting stories from our partners. Follow along and get involved on Twitter and Facebook with the hashtag #Marchis4Nutrition.

The Global Panel on Agriculture and Food Systems for Nutrition is an independent group of influential experts with a commitment to tackling global challenges in food and nutrition security. It works with international, multi-sector stakeholders, to help governments in low and middle-income countries develop evidence-based policies that make high-quality diets safe, affordable and accessible.

The Global Panel’s policy briefs already make the case for aligning food systems to deliver healthy diets. But why is this particularly important for girls and women? And how can good nutrition contribute to achieving the Sustainable Development Goals?

Women are particularly vulnerable to malnutrition in all its forms. On one hand, over half of young women and adolescent girls in a wide range of low and middle-income countries are not meeting their micronutrient needs. Women typically eat a lower quantity and variety of nutritious foods than their male counterparts – even though, at specific stages in the lifecycle, women require more dietary iron than men and more proteins*. On the other hand, overweight and obesity rates are rising. In Egypt, for example, overweight and obesity affect 76% of all women over 15 (vs 64% of men*); and more than 1 in 5 women are overweight in Nigeria.

The Global Panel believes that addressing poor quality diets and malnutrition, particularly for women and girls, is critical to advancing progress on the 2030 Agenda for Sustainable Development (policy brief). To take a few of the global goals:

Improving access to healthy diets for women and girls will accelerate progress on SDG 1 (related to poverty reduction) and SDG8 (economic growth). Malnutrition fuels poverty. It is those with the least social, economic and political power who are most affected by malnutrition*. Ensuring high-quality diets for vulnerable groups, including women, will deliver several benefits, for example through gains in labour productivity and future earning potential. In terms of household income, each added centimetre of adult height is associated with almost 5% increase in wage rates*. Eliminating malnutrition in Africa and Asia would allow more women to enter the workforce, and could unlock the equivalent of 11% in lost GDP each year.

Investing in women’s nutrition will also promote health and well-being for women and their children (SDG 3), as well as boosting gender equality and good education (SDGs 4 and 5). Experiencing any form of malnutrition during pregnancy can have lasting repercussions on foetal and child development. Maternal protein restriction increases the risk of high blood pressure in childhood, and of cardiovascular disease later in life*. Poor female nutrition early in life impacts learning potential and increases maternal health risks Malnourished women, as well as men, are more likely to be affected by non-communicable diseases such as heart disease, strokes, and type 2 diabetes whereas well-nourished girls experience better educational outcomes and the ability to delay early marriage and pregnancies*.To provide a fairer start to women, we must ensure they have access to nutritious and healthy diets, at all stages of life.

Three years into the UN Decade of Action on Nutrition, it is time to take concerted action to improve access to quality diets and nutrition for girls and women and to recognise the central role this plays in promoting economic and social development.

#Marchis4Nutrition: What if moms had access to affordable, safe and nutritious foods?

In honor of National Nutrition Month, 1,000 Days is hosting its annual #Marchis4Nutrition campaign to amplify the critical role the world’s mothers play in nourishing the next generation. All month long, we have been imagining a world in which moms have the support they need to give their children a healthy start to life. This week we’re asking:

What if moms had access to affordable, safe and nutritious foods?

Moms and their babies need access to healthy and safe foods in order to thrive. Yet, 1 in 6 young children in the United States live in food insecure households. And around the world, over 800 million people are chronically undernourished, lacking enough food to eat. Too many families worldwide simply don’t have access to affordable and nutritious food because of food scarcity or poverty.

Further, the safety of infant and toddler foods isn’t always guaranteed. Some infant and toddler foods are contaminated with bacteria like salmonella or heavy metals like lead, which can have a long-lasting impact on the health and development of young children. But the contaminates aren’t always publicly reported, thus leaving parents blindly unaware of the toxins in their foods.

Ensuring women and young children have access to safe, affordable and nutritious foods would result in healthier moms, healthier babies and better birth outcomes. Fewer babies would be born low birth weight, children’s brains and bodies would develop well, and ultimately more children would have the opportunity to reach their full potential.

 “If moms had access to affordable, safe, and nutritious foods, more children could survive and thrive.”
– Asma Lateef, Director of Bread for the World Institute

So, what will it take to ensure women and children have access to the healthy foods they need?

Proven-effective programs that reach low-income families with healthy foods and nutrition education are a critical investment in the health and well-being of babies and young children. In the U.S. the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) helps improve the diets and health of over 7 million women, infants and children every month. Women participating in WIC receive vouchers for whole grains, vegetables and other healthy foods, along with nutrition counseling and breastfeeding support. The results are clear: women who participate in WIC give birth to healthier babies that are more likely to survive infancy.

Around the world, counseling and training helps provide women with the knowledge they need to understand what foods are healthy and safe for them and their families. In Uganda, biofortification programs like those run by HarvestPlus and World Vision help rural families grow nutrient rich foods and also teach communities about the benefits. Mothers like Esther are now able to give their children a healthy start with nutritious foods like her homegrown sweet potatoes.

To ensure that infant and toddler foods are as safe as possible we must create and enforce stronger food safety regulations. Organizations like the World Health Organization, the U.S. Food and Drug Administration and Codex must continue their work on food safety.

“Parent should be focused on getting the most nutritious food for their child. They should not have to worry about contaminants such as lead, inorganic arsenic, perchlorate and phthalates in their children’s food.”
– Tom Neltner, Chemicals Policy Director for Environmental Defense Fund

ALL families need support in accessing safe, affordable and nutritious food – and that starts with empowering moms with information to make healthy choices for their families. Join the #Marchis4Nutrition conversation on Facebook and Twitter this month and tell us what you think: What does the world look like if moms and young children had access to safe, affordable and nutritious food?

Guest Post: Conquering Nutrition Myths in Myanmar – Access to Nutritious Foods #Marchis4Nutrition

In honor of National Nutrition Month in March, 1,000 Days is amplifying the critical role the world’s mothers play in nourishing the next generation through our annual online #Marchis4Nutrition campaign. Throughout the month, we will also be highlighting stories from our partners. Follow along and get involved on Twitter and Facebook with the hashtag #Marchis4Nutrition.

Save the Children believes every child deserves a future. They work in 120 countries around the world to give children a healthy start in life, the opportunity to learn and protection from harm. Save the Children does whatever it takes for children – every day and in times of crisis – transforming their lives and the future we share.

Save the Children works in many communities with mothers such as Mya Cherry to provide robust health and nutrition programs that save children’s lives and ensure they grow up healthy.

This is Mya Cherry’s story from Shwe Pyi Thar, Myanmar.

When I became pregnant with my fifth child, I received nutrition knowledge training from Save the Children. I realized how to make children physically and mentally well developed during their first 1,000 days. Save the Children also provides cash transfers for pregnant women and for women with children under 2-years. It significantly solves the financial problem of our family.

Regarding the nutrition, I have changed some old myths. In the past, my elders told me not to have green vegetables and bananas during the pregnancy as it would make the babe stronger. Actually it was wrong. Now, after receiving the nutrition knowledge training, I try to eat everything I like.

When my elder babies reached 45 days, I fed them foods whether they wanted it or not. I thought that it would make them healthy. At night, they could not sleep but vomited because of the food. They also got sick very easily. Now, I can nurture very well to my youngest baby thanks to the nutrition training from Save the Children. I fed my youngest child only after 6 months. Her appetite is also very good. Her health is also good compared to her elders. My eldest son is suffering from malnutrition. He is much shorter and smaller compared to his age. Not to be like her brother, I am taking care of my youngest daughter according to the training instruction from Save the Children. I attended the nutrition and financial education training together with my husband. He understands and supports me well.

Even though my husband and I have only primary education, we have tried our best during the training. I have received these training when I had 6-month pregnancy. I had followed the pregnancy instructions since then. I delivered my elder babies with the midwife before. With my fifth pregnancy, I had changed. I had received the proper pregnancy care from the local hospital. Therefore, I had a smooth labor with my fifth baby.