Month: February 2021

A study published in the January 2021 issue of Pediatrics provides new evidence of the importance of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in improving families’ health and well-being during the first 1,000 days.

Established in the 1970s, WIC provides healthy foods and other services to low-income women, infants, and children up to age 5 years in the United States. In October 2009, the WIC food packages were revised for the first time since the program’s establishment to increase access to healthy foods. This included introducing a $10-per-month voucher for fresh fruits and vegetables and requiring that purchased milk be low-fat and bread be whole grain. While previous studies have found that the revised WIC food packages improved maternal and child diet quality, perinatal and birth outcomes, and breastfeeding practices, the present study was the first to evaluate long-term effects on children’s growth and development.

The study compared measures of growth and socioemotional and cognitive development in children of WIC recipients and nonrecipients during pregnancy before and after the 2009 food package revisions. Examining longitudinal data from Tennessee, the researchers found that children whose mothers received the revised WIC food package during pregnancy had better growth at 12 months and better cognitive development at 24 months than other children in the study. However, there was no relationship between mothers receiving the revised WIC food package in pregnancy and other outcomes, including growth at 24 months or 4-6 years, socioemotional development at 12 or 24 months, or cognitive development at 4-6 years – perhaps due to limitations of the study. The authors suggest that improved maternal nutrition during pregnancy could have long-lasting effects on the health and development of children through a process known as “fetal programming.”

In the future, more substantial updates to the WIC food package could be a useful strategy to reduce health disparities and ensure that all women and children have a healthy first 1,000 days. In January 2017, the National Academies of Sciences, Engineering, and Medicine (NASEM) completed its most recent review of the WIC food packages. NASEM recommended numerous updates to the variety, quality, and value of WIC-approved foods, such as increasing the amount of the voucher for fruit and vegetable purchases and offering options that meet cultural preferences and special dietary needs. Additionally, for the first time ever the 2020-2025 Dietary Guidelines for Americans included recommendations for pregnant and breastfeeding women, infants, and toddlers. 1,000 Days calls on USDA to continue improving the nutrition and health of WIC participants by updating the WIC food packages consistent with the 2017 NASEM recommendations and the 2020 Dietary Guidelines.

Many new moms have concerns about breastfeeding in the context of the COVID-19, and unfortunately there is an abundance of misinformation and disinformation available online. On behalf of the COVID-19 Infant Feeding Working Group, the Program for Appropriate Technology in Health (PATH) has released a brief focusing on breastfeeding related questions that have arisen during the pandemic. PATH highlights the following key points:

Benefits of breastfeeding significantly outweigh the potential risk of COVID-19 transmission.

To date, active COVID-19 virus has not been found in amniotic fluid, cord blood, vaginal discharge, neonatal throat swabs, or breast milk. Transmission from mother to infant via respiratory droplets can occur post-delivery, so if a mother is symptomatic or confirmed COVID-19 positive, standard precautions such as wearing a mask (medical grade if possible) and hand washing before and after touching her baby are recommended. A mother who is feeling too ill to breastfeed can still provide her baby with breast milk by expressing manually, pumping or using donor milk.

Mothers and newborns should remain together throughout the day and night and have regular skin-to-skin contact, including kangaroo mother care, especially during the establishment of breastfeeding. Aside from facilitating breastfeeding, skin-to-skin contact and kangaroo care improve newborn temperature regulation, blood glucose control, and maternal-infant attachment. While COVID-19 antibodies in breast milk are still being studied, bioactive components of human milk not only protect the infant against infections but improve neurological, cognitive, and immunologic development.

The risk of COVID-19 infection in infants is low, and even if infected, infants typically experience mild symptoms or are asymptomatic. In contrast, the consequences of not breastfeeding and separating mother and child can be significant. Breastfeeding promotes infant health and development and protects against other infections that put babies at risk.

From 1,000 Days Initiative Director, Blythe Thomas

Next month marks the one-year anniversary when the World Health Organization declared COVID-19 a global pandemic. In this year, we’ve experienced a triple crisis of a global pandemic, a national reckoning on racial justice and a downfallen economy. COVID-19 has especially shined a light on the health inequalities that have been pervasive in our society.

I work in the public health sector, with public health defined as the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. My colleagues across the public health sector have been tested like never before. This month especially, Black History Month, I’ve been reflecting on the Black men and women who have made instrumental contributions to public health in the United States, some who are recognized globally and some who have personally influenced my career.

I was fortunate to start my journey at the American Red Cross, where I joined the Biomedical Services division to increase awareness about the need for voluntary blood donations. Still today, every 2 seconds, someone needs blood in this country. Upon joining the organization, I learned about Dr. Charles Richard Drew, the African American surgeon and researcher who organized America’s first large-scale blood bank and trained a generation of Black physicians at Howard University. His method for the collection banking of blood products and the logistics of collecting and distributing blood saved countless lives in the trenches of World War II and the wards of military and civilian hospitals.

While at the Kansas Health Foundation, I learned about social determinants of health and especially how systemic racism is a public health crisis. Racism plays a leading role in the social determinants of health such as income, education level, and healthy childhood development. To break that down further: a person’s zip code can be a better predictor of long-term health and lifespan than one’s own DNA. While at KHF, Dr. Camara Phyllis Jones was the president of the American Public Health Association, and I was so inspired by her brilliance, and also her grace. In 2015, she launched a National Campaign Against Racism at APHA. She spoke (and continues to speak) with such strength and determination that … “Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need. Health disparities will be eliminated when health equity is achieved.”

Also while at KHF, I learned about Adverse Childhood Experiences (ACES) from Dr. Nadine Burke Harris, Founder of the Center for Youth Wellness and current Surgeon General of California. It was the first time I learned about the relationship between early childhood adversity and negative lifelong health effects. Her research found that the long-term impact of ACEs determined future health risks, chronic disease, and premature death. Individuals who have experienced multiple ACEs also face higher risks of depression, addiction, obesity, attempted suicide, mental health disorders, and other health concerns. And according to UNC Jordan Institute for Families: “Exposure to racism, and other ACEs, affect our health largely through the body’s stress response system. This ‘toxic stress’ destroys critical regulation systems in our bodies and brains and can ruin our health over time. With racism on full display in the media via police killings of Black people and the rise of right-wing white supremacist groups into national politics, the stress from the threat of racism is likely very high today for Black children.”

Now at 1,000 Days I continue to be inspired by colleagues who are helping us make a difference for those mothers and children who are most vulnerable, in particular, families of color who are overburdened and under-resourced. As a result, there are glaring disparities in the health and well-being of moms and babies. I learned this through my own studies and also through colleagues across the philanthropic community, especially Dr. Risa Lavizzo-Mourey, president emerita and former CEO of the Robert Wood Johnson Foundation (RWJF). While at the Partnership for a Healthier America and now at 1,000 Days, I followed as she led the way to set a vision for a Culture of Health, spearheading health initiatives to create healthier, more equitable communities. And my current leader, FHI Solutions Managing Director Nadra Franklin, who has extensive experience in health research and implementation, now leads three centers of excellence that promote healthy growth and development through nutrition. Nadra’s vision of nutrition focused, innovation led, powers a unique approach to improve nutrition, to save lives and create a healthier, more productive and secure world.

While I am humbled every day by the leaders who inspire me, I am especially grateful this year, this Black History Month, for the men and women who have made such a tremendous impact on my life and the lives of countless others.

We are now one month into the 117^th Congress and members in the House and Senate have already begun work on a number of bills important to families in the 1,000-day window. Here are a few things we’re keeping an eye on:

COVID relief: House and Senate pass budget resolution

Last week, the House and Senate voted to advance a budget resolution, the first step towards passing President Joe Biden’s $1.9 trillion proposed American Rescue Plan. This much-needed coronavirus relief package would advance a number of 1,000 Days’ key priorities, investing $3 billion in WIC, extending a provision to increase the maximum SNAP benefit to food insecure families, provided $11 billion in much needed funding for key global health programs and extending and expanding the emergency paid sick days and paid leave tax credits originally passed last year, but unfortunately without the mandate that employers provide workers with much-needed leave. Additionally, the package would create a national vaccination program and provide emergency funding to state and local governments to support programs like Medicaid. While the details of the package are still being finalized, as proposed, it would provide significant relief to families, allowing them to stay healthy and secure amidst the ongoing pandemic. 1,000 Days will continue to work with Congress and the Administration to advance policies to improve the health and wellbeing of moms, babies and their families, in the U.S. and around the world.

Important paid leave bill reintroduced

Rep. Rosa DeLauro (D-CT) and Sen. Kirsten Gillibrand (D-NY) reintroduced the Family and Medical Leave Insurance (FAMILY) Act last week, with nearly 200 cosponsors in the House and more than 30 in the Senate. The FAMILY Act, which was reintroduced on the 28^th anniversary of passage of the Family and Medical Leave Act, would create a comprehensive, national paid family and medical leave program. Whether for a public health emergency, a personal health emergency, or when welcoming a new child, families need access to paid leave to attend to their own health needs and those of their loved ones without risking their economic security. Now more than ever, paid leave is a public health imperative. 1,000 Days is pleased to endorse the FAMILY Act and we will continue working closely with our partners and champions in Congress to make paid leave a reality for all workers and all families.

Legislation offered to address the Black maternal health crisis

This week, Reps. Lauren Underwood (D-IL) and Alma Adams (D-NC), co-chairs of the Black Maternal Health Caucus, as well as Sen. Cory Booker (D-NJ) are reintroducing the Black Maternal Health MOMNIBUS Act. This comprehensive, bipartisan legislation, which 1,000 Days is proud to endorse, aims to improve the physical and mental health of moms in the United States and address the Black maternal health crisis. The MOMNIBUS takes a holistic, broad approach to addressing the social determinants of health, investing in data collection, growing and diversifying the health workforce, and combating implicit bias in healthcare settings. 1,000 Days looks forward to continuing to work with the Black Maternal Health Caucus and its members to ensure that all moms, regardless of their race, class or immigration status, can have a healthy first 1,000 days and beyond.

Every year, malnutrition kills more children than AIDS, malaria, and tuberculosis combined.

COVID-19 related disruptions to global food and health systems have caused rates of malnutrition to rise substantially. We know that the science stands strong on the 1,000-day window as a game-changing moment. If we can get that time between a woman’s pregnancy and her baby’s 2^nd birthday right, we can change the trajectory of a family, their community, our societies, and our world.

The series will tackle food production and environmental sustainability, as well as food consumption and utilization. We must challenge ourselves to question:

• How can the access, availability, and distribution of healthy food be fairer?
• What role does policy, legislation and behavioral norms play in determining who gets to decide what we eat, who eats what, and what is considered “nutritious” and “enough”?
• How can food systems deliver on nutrition outcomes and be climate smart and gender equitable?

Throughout the series, 1,000 Days and our colleagues within FHI Solutions will help lead discussions about the role of food and health systems to nurture our most vulnerable families in their 1,000-day window, and importantly highlight the innovative, proven solutions to end preventable deaths.

This series is timed to the lead up of the 2021 U.N. Food Systems Summit, where a key focus is ensuring access to safe and nutritious food for all. And this year, the Nutrition Year of Action, milestone events throughout the year will focus on mobilizing new policy and financial commitments with the potential to transform the way the world tackles the global challenge of malnutrition, culminating in the Nutrition for Growth Summit in Japan in December 2021.

Malnutrition has many root causes including poverty, lack of education, erratic seasonal crop cycles, climate change, women’s inequality, and more. The world is ready to end malnutrition-related child deaths. Join us by following the series on social with #DevexSeries and @1000Days and visiting the Future of Food Systems for new articles and resources.