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Author: Allyson Garner

1,000 Days Submits Comments to USDA and HHS for Next Edition of the Dietary Guidelines for Americans

The U.S. Departments of Health and Human Services (HHS) and Agriculture (USDA) are preparing for the next edition of the Dietary Guidelines for Americans. They recently proposed a list of scientific questions to inform the next version, with a focus on diet and health outcomes across the lifespan. In response, 1,000 Days submitted comments emphasizing the critical importance of nutrition in shaping future health and outcomes. Our comments specifically recommend adding developmental milestones as outcomes of study for infant and toddlers, including key questions on maternal and child nutrition and health outcomes from the 2020 Dietary Guidelines Advisory Committee report, and updating research on breastmilk composition and consumption.

See the comments here.

U.S. Breastfeeding Committee’s Statement on the Formula Shortage

The following guidance is also available from the Academy of Breastfeeding Medicine and HealthyChildren.Org.

Dear Members,

It’s been a long week/month/year (already, here in May). We see you. We are you. Much love.

As the United States faces a serious shortage of infant formula, we know that no baby should ever go hungry. Families are scared and stressed, and like every other crisis facing our nation, BIPOC and economically vulnerable communities are pressed even harder. This is a national crisis.

Long standing public health advocates know this was predictable and thus preventable. The USBC-Affiliated COVID-19 Infant & Young Child Feeding in Emergencies Constellation published a Statement at the start of the pandemic outlining actions needed to prevent the formula shortage and care gaps seen at that time from growing to a dangerous level. Being prescient is only valuable in the context of investment, action, and policy change to ensure every family has access to care. Yet here we are.

A robust infrastructure to support infant and young child feeding in emergencies includes both inventories of available commercial milk formula and lactation support and resources in every community. Public officials are currently calling for increased production of formula – which is desperately needed – yet without also investing in lactation support in every community. This exacerbates existing gaps, and as such feels short-sighted. Thank you to all the organizations lifting up resources and information on boosting milk supply, re-lactation, human milk donation, informed consent for safer milk sharing, all while calling out the systems failure that caused this to be necessary.

Long term, this is still a call to action to build systems and infrastructure to ensure that breastfeeding/human milk feeding is the easy and obvious feeding choice for most families. This includes routine skin to skin at birth; continuity of care from trained lactation support providers; family paid leave; workplace accommodations; a regulated commercial milk formula industry that invites formula-feeding parents to the table as valued stakeholders; a national network of milk banks; and IYCF-E infrastructure for disaster relief. Systems, in other words, that hold us all in care. Collectively we can build the resiliency to support a single community during a flood, a region during a power outage, or a nation during a pandemic or supply chain crisis. Dear choir – we know you know this sermon.

As the nation grapples with the immediate and present impact of this emergency, we need to do everything we can to support infant nutrition, including ensuring access to lactation support, supplies, and accommodations, donor milk, and infant formula. Organizations and agencies from across the nation are mobilizing in response to the shortage, offering support and messaging response according to the scope, stance, and capacity within their reach.

Throughout its history, the U.S. Breastfeeding Committee has worked to ensure food security for our nation’s infants by addressing gaps in the policy landscape with policy, systems, and environmental change solutions that include building an infrastructure for infant and young child feeding in emergencies. We remain committed to this cause and will continue to curate and amplify resources from the field, for the field, so that you are equipped to support the families you serve.

Thank you for all you are doing, including taking respite as you need.

Focus on Nutrition During National Women’s Health Week

By:  Blythe Thomas, Initiative Director, 1,000 Days of FHI Solutions

Minerva Delgado, Director of Coalitions & Advocacy, Alliance to End Hunger

Not nearly enough time or attention is spent discussing and acting upon when “good nutrition” for an individual should start. The answer? Before the individual is even born. This week is National Women’s Health Week and marks an important time for the nutrition and anti-hunger community, individuals, and policymakers, to reflect on what we can do to promote and improve the health of women, children and families. We must focus on supporting policies that build a healthier and more equitable future for all pregnant, birthing, postpartum, and parenting people and their children.  

The 1,000-day window, which spans from pregnancy to age 2, marks one of the most crucial times to provide vital maternal and infant nutrition interventions. The nutrition community has coalesced around this critical window working to ensure mothers, children and families have access to the nutrition they need for vibrant futures. This goal is unfortunately – but unsurprisingly – difficult to achieve across the board. Factors such as race or where a child is born should not affect health and well-being; however, this is a reality in many communities. In particular, families of color and low-income families are more often overburdened with barriers to accessing nutrition and are under-resourced. As a result, there are glaring disparities in the health and well-being of women and children from these households. 

Adequate nutrition is fundamental to the overall well-being of a community because good nutrition impacts more than just physical health. Good maternal nutrition during pregnancy fuels the development of a baby’s rapidly growing brain so by the time that a baby is born, their brain will contain 100 billion neurons. We also know, for example, that children with access to healthier, more nutritious meals are better able to concentrate in school and enjoy better educational outcomes. Similarly, adults who can easily access and maintain a healthy diet benefit from improved health and economic opportunities. Addressing inequities in access to healthy and nutritious foods cannot be ignored. We must prioritize interventions that give every family the opportunity to be healthy.  

To that end, there are a number of programs that merit continued support and strong expansions, such as the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Child and Adult Care Food Program (CACFP). For example, WIC has bridged the gap between medicine, food, and nutrition better than almost any federal program, leading to improved nutrition intake, healthier pregnancies and improved birth outcomes. Congress has temporarily increased the overall value of WIC’s fruit and vegetable benefit (or Cash Value Benefit (CVB)) through the end of September 2022. So far, this has led to better access to nutritious foods for over 4.7 million WIC participants. Making the increased benefit permanent will significantly close nutrition gaps for women and their children. 

Improving nutrition also means supporting programs like the recently expired monthly Child Tax Credit (CTC). The revamped CTC monthly payment proved to have an astonishing impact on lifting children and families out of poverty. In 2021, Congress expanded the CTC and made the full credit available to low-income families who previously did not qualify because their earnings were too low. Families were allowed to receive the credit in monthly increments, which was vital in helping families with their everyday expenses like buying nutritious food. It is estimated that 3.7 million children were kept out of poverty in December 2001 when the last child tax credit payments were made. Further, nearly half of families who received the tax credits used the extra funds to purchase food helping to address nutrition insecurity around the country. In January, the first month without the deposits, those gains were lost and 3.7 million children again fell into poverty. 

But we must support the overall health and well-being of women and families with comprehensive approaches to address the root causes of poverty and malnutrition. Employers must implement family-friendly policies and programs in workplaces and communities to support women at home and at work. This includes providing workers with sufficient paid family leave, as well as ensuring equitable access to the lactation services and support women need to meet their breastfeeding goals. These policies help make the workplace and our society a safe and enabling environment. The recent pandemic and subsequent inflation have highlighted not only the critical nature of poverty and nutrition programs, but also the vulnerabilities and gaps in supporting those who need it most. All future policies must prioritize making programs more equitable and effective. While Congress has many competing priorities, we know that voters across all demographics deeply care about ensuring women and their children have access to the nutrition they need to be healthy. For example, a recent bipartisan poll by ALG Research/McLaughlin & Associates, on behalf of the National WIC Association and Alliance to End Hunger, reveals strong support for WIC among likely 2022 voters – 83% total support for the program, and approximately 75% support for expanding the value of the WIC food package, expanding postpartum eligibility, and modernizing WIC services.  

This week, let’s reflect once again on the fundamental importance of nutrition for women and girls across the country, and urge Congress to make access to healthy foods and investment in nutrition programs a priority. Ensuring the health and well-being of those who are pregnant and their children is critically important to our nation’s future and requires both focus and determination of policymakers and advocates. 

1,000 Days, an initiative of FHI Solutions, fights to win support for policies and investments in the wellbeing of mothers, babies and toddlers in the U.S. and around the world. 

Alliance to End Hunger unites diverse sectors to address today’s hunger and malnutrition needs and to solve the root causes of hunger at home and abroad. 

Paid Family Medical Leave Remains Critical for Low-Income Pregnant and Postpartum Women

By: Daphna Dror, PHD, RD

The lack of national, comprehensive, and paid family medical leave in the United States has significant consequences for low-income women, especially those who are pregnant or have recently given birth. Many women risk their own or their child’s health to continue working throughout pregnancy and the early postpartum period in order to pay bills and provide for dependents. Only seven states and the District of Columbia have passed their own paid leave programs, meaning far too many new mothers must choose between caring for themselves and bonding with their newborn or making ends meet. 

Paid leave:

  • Supports healthier pregnancies. Financial concerns due to lost wages may prevent low-income women from seeking regular prenatal care, which itself is associated with better pregnancy and birth outcomes. Paid leave reduces the risk of preterm birth, low birthweight, and infant mortality (1)
  • Increases breastfeeding initiation and duration. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months followed by a combination of complementary foods and breastmilk for at least 12 months (2), yet new mothers who plan to return to work before 12 weeks or to work full time are less likely to opt for exclusive breastfeeding (3). A recently published study of participants in the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) found that amongst women who had worked prenatally, returning to work within 3 months postpartum significantly decreased the odds of breastfeeding for the first year (4). Paid time off can alleviate the financial stress of combining work and breastfeeding (5,6).
  • Improves the physical and mental health of mother and baby postpartum. While postpartum depression (PPD) occurs in approximately 11% of all US mothers, a qualitative study in low-income women found that 35% experienced PPD or sadness (1). Nearly one third of low-income mothers who returned to work reported that employers were not understanding of postpartum needs, most commonly requiring more time off (1). Mothers who have access to paid leave and other work accommodations can minimize financial strain and career disruptions while improving their own health, their baby’s health and their bond with their baby.
  • Reduces maternal and infant racial and ethnic disparities. Women of color are disproportionately affected by lack of access to paid leave, exacerbating perinatal health disparities (7). Compared with Caucasians, African-American mothers in the United States are more than three times as likely to die of pregnancy-related causes (8); infants born to African-American mothers have more than twice the mortality rate of infants born to Caucasian mothers (9). Women of color are overrepresented in part-time, seasonal, and low-wage jobs, employment categories least likely to offer paid leave (7).

Of 41 high- and middle-income countries, the U.S. is unique in lacking nationwide paid maternity leave, paternity leave, or parental leave (10). Only 19% of U.S. workers have access to paid family medical leave, with even lower access amongst those who work part-time, in low-wage industries, at small firms, or who are not unionized (11). Universal access to paid family leave is imperative to ensure that all families in the United States have a healthy first 1,000 days and a strong foundation to thrive.


References

1.     McClanahan Associates, Inc., 1,000 Days. Qualitative Paid Leave Report: Furthering our Case for Paid Leave in the United States.

2.     Eidelman AI, Schanler RJ. Breastfeeding and the Use of Human Milk. Pediatrics. 2012 Mar;129(3):e827-41.

3.     Mirkovic KR, Perrine CG, Scanlon KS, Grummer-Strawn LM. In the United States, a Mother’s Plans for Infant Feeding Are Associated with Her Plans for Employment. J Hum Lact. 2014 Aug;30(3):292–7.

4.     Hamner HC, Chiang KV, Li R. Returning to Work and Breastfeeding Duration at 12 Months, WIC Infant and Toddler Feeding Practices Study-2. Breastfeed Med. 2021 Dec;16(12):956–64.

5.     Rojjanasrirat W, Sousa VD. Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA. J Clin Nurs. 2010 Jul;19(13–14):2014–22.

6.     Johnson AM, Kirk R, Muzik M. Overcoming Workplace Barriers: A Focus Group Study Exploring African American Mothers’ Needs for Workplace Breastfeeding Support. J Hum Lact. 2015 Aug;31(3):425–33.

7.     Goodman JM, Williams C, Dow WH. Racial/ethnic inequities in paid parental leave access. Health Equity. 2021 Oct 13;5(1):738–49.

8.     Howell EA. Reducing disparities in severe maternal morbidity and mortality. Clin Obstet Gynecol. 2018 Jun;61(2):387–99.

9.     Ely DM. Infant Mortality in the United States, 2018: DataFrom the Period Linked Birth/Infant Death File. National Center for Health Statistics; 2020 Jul.

10.     Chzhen Y, Gromada A, Rees G. Are the World’s Richest Countries Family Friendly? Policy in the OECD and EU. Florence, Italy: UNICEF Office of Research; 2019.

11.     National Compensation Survey: Employee Benefits in the United States. U.S. Department of Labor, U.S. Bureau of Labor Statistics; 2019 Mar.

Three Big Things a White House Conference on Nutrition Must Deliver

Image credit: Diego Cambiaso

After more than 50 years, a White House Conference on Food, Nutrition, Hunger and Health is within our grasp. The first conference in 1969 resulted in some of today’s most critical programs to improve food security and nutrition such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), and the National School Breakfast and Lunch Program. Revisiting this pivotal conference gives us an additional opportunity to build upon gains over the last five decades to continue to create conditions for families to thrive. And there is no better place to start than from action at the People’ House.

The next White House Conference, to be held in 2022, provides an opportunity to align government, industry, academia, civil society, health care providers, public health and philanthropy around a roadmap to end hunger and improve nutrition and health.

1,000 Days works every day to create a healthier and more equitable future for all pregnant, birthing, postpartum, and parenting people and their children. We lead the fight to build a strong foundation for mothers, children, and families to thrive. The first 1,000 days from pregnancy to age 2 offer a window of opportunity to create a healthier and more equitable future for all.

What three things should this White House conference deliver to fully realize this opportunity for parents and children?

1.  Unity. The science and interventions known to have the greatest return on investment must be prioritized. We know that poor nutrition in the first 1,000 days can cause irreversible damage to a child’s growing brain, affecting their ability to do well in school and earn a good living—and making it harder for a child and their family to rise out of poverty. It can also set the stage for obesity, diabetes, and other chronic diseases which can lead to a lifetime of health problems. The government, philanthropy, private sector and civil society together must embrace and unify around the irreputable science that nutrition for the mother during pregnancy, while breastfeeding and the right nutrition through infancy and toddlerhood, is the most impactful, critical time.

2.  Equity. Factors such as the color of our skin or the neighborhood we live in should not affect our health and well-being; however, this is a reality in many communities. Social determinants of health, which are conditions in the places where people live, learn, work, and play – as well as the chronic stress that comes from issues of inequity, like racism – mean that some families do not have access to the resources and support they need to be healthy and prosper during the first 1,000 days and beyond. In particular, families of color and low-income families are more often overburdened and under-resourced. As a result, there are glaring disparities in the health and well-being of moms and babies from these communities. Addressing inequity in access to healthy and nutritious foods cannot be ignored. We must prioritize interventions that support every family to have an opportunity to be healthy.

3.  Action. There is no time to lose. The last White House conference yielded some of the greatest nutrition programs that have continued to save and enhance lives through generations. A focus on identifying specific actions across various sectors must be built into the conference goals from the start. We must be bold, think big, reach across the aisle and not be afraid do whatever it takes to put families on a better path. The White House conference can convene leaders who have the power and influence to drive action for immediate and long-term benefits to families and children.

We stand ready to support a strong, unifying, equitable and action-focused White House Conference on Nutrition and help serve as a voice for the millions of families whose lives are impacted every day by a lack of access to healthy and nutritious foods during the critical 1,000 days.

Work at 1,000 Days: Open Positions

1,000 Days leads the fight to build a strong foundation for mothers, children, and families to thrive. The first 1,000 days from pregnancy to age 2 offer a window of opportunity to create a healthier and more equitable future for all pregnant, birthing, postpartum, and parenting people and their children. Join us and help achieve our mission to make health and well-being during the first 1,000 days a policy and funding priority, both in the U.S. and around the world.

The organization is hiring two, full-time, remote positions with office space in the Washington D.C. area available:

Policy and Advocacy Officer (6-8 years experience) The ideal candidate for this position develops, cultivates and leverages great relationships with decision-makers, legislators, fellow nonprofit organizations, policy experts and researchers to deliver on the 1,000 Days’ domestic policy priorities and builds effective coalition efforts and campaigns. The candidate will research, monitor, analyze and respond to federal legislation related to nutrition, paid leave, maternal and child health and healthcare as established in our 2022 Advocacy Agenda. Candidates must be actively interested in working with an organization that is making the needs of vulnerable families a policy and funding priority. The position reports to Solianna Meaza, Director of Policy and Advocacy.

Advocacy and Research Associate (2-4 years experience) The primary role of this candidate is to track and analyze relevant research, reports and policy developments, as well as provide research and writing support around key policies and programs impacting families, including federal nutrition programs, federal dietary guidelines, paid leave and healthcare. The candidate will translate policy and research information for a variety of audiences and produce written materials such as policy briefs, position papers, blog posts, social media posts and reports. The ideal candidate has advanced credentials, such as a Master’s in Public Health, a Registered Dietitian, or similar. The position reports to Blythe Thomas, Initiative Director.

Cultivating a diverse and inclusive team is an essential component of 1,000 Days’ work to advance equity. Candidates of all backgrounds are strongly encouraged to apply. We are committed to fostering a workplace culture that is welcoming and inclusive to staff of different races and backgrounds. We seek to foster an environment where all staff feel a sense of belonging and are affirmed. We actively welcome and value staff with different experiences, backgrounds, attributes, abilities, and perspectives.

We look forward to growing the team of leaders who cares deeply for the health and wellbeing of families here and around the world.

Ensuring Women Have Access to Proper Nutrition Grows Their Power

Image Source: Jonathan Torgovnik, Getty Images, Images of Empowerment

By: Megan Deitchler, Initiative Director, Intake; Sandy Remancus, Initiative Director, Alive & Thrive; Blythe Thomas, Initiative Director, 1,000 Days

Every person has the fundamental human right to access safe, affordable, and nutritious foods, but women and girls are twice as likely to suffer from malnutrition as men and boys due to a combination of biological, social, and cultural factors. We must do better to change this reality. Ahead of this year’s International Women’s Day, 1,000 Days and our sister Initiatives at FHI Solutions, Alive & Thrive and Intake, are calling for greater action to improve the nutrition of women and girls worldwide.

We know that well-nourished women and girls are healthier, more productive, and more likely to finish school. Malnutrition is a barrier that keeps women from accessing their full potential, which reinforces women’s oppression in all aspects of their lives. Good nutrition and women’s empowerment go hand in hand. A more intentional focus that targets improving women’s’ and girls’ nutrition is critical to making concrete, cost-effective, and sustainable improvements to the status of girls around the world. Simply put – ensuring women have access to proper nutrition can help them grow their power. Consequently, gender equality and increasing women’s decision-making powers are crucial to overcome nutritional vulnerabilities and break the inter-generational cycle of malnutrition.

Good nutrition is an essential building block in our fight for gender equality, but our approaches thus far have been siloed. Considering the interlinks between a woman’s health and her ability to claim her agency, actors and service providers across health, social protection, agriculture, and women’s empowerment sectors must prioritize optimal nutrition for women in their own right. Failure to harness a nuanced approach to these interlinked issues, from the community level to the global, will continue to leave women behind.

Over the next two years, FHI Solutions will work hand in hand with our diverse and multi-sectoral allies, ranging from community organizations to government leaders, to galvanize global- and country-level momentum for a compelling Women’s Nutrition Action Agenda. Through this Action Agenda, we aim to:

  1. Advance women’s nutrition as a global development priority of major donors and in target priority low- and middle-income countries (LMICs)
  2. Inform and inspire more and better use of new and existing financing for nutrition on priority World Health Assembly nutrition targets (anemia, low birthweight, and exclusive breastfeeding) from target LMICs and donors
  3. Influence delivery platform gatekeepers in health, including primary health care / Universal Health Coverage platforms, as well as other sectors to integrate preventive nutrition interventions in target LMICs
  4. Advocate for the use of reliable, validated metrics, such as the Global Diet Quality Score, to track progress in achieving healthy diets for all, especially women and girls

Nutrition programming is an underleveraged tool in the fight to advance girls’ rights and empowerment. By leveraging targeted nutrition interventions as a key part of gender equality programming, women’s empowerment actors can give a cost-effective boost to their investments and move the world back closer to reaching Sustainable Development Goal 5 – SDG 5. We are committed to working together with critical partners, both inside the global nutrition community and beyond, as we build a multi-sectoral policy, advocacy, and communications effort to inspire national and international commitment to, and scaled-up investment for, women’s nutrition. We must ensure the nutrition and health of girls and women to fully support their ability to build vibrant lives of their own making.

Kicking Off #March4Nutrition – Join Us All Month Long

In honor of National Nutrition Month, 1,000 Days is kicking off our annual #March4Nutrition campaign to amplify the importance of nutrition for moms and babies around the world. We invite you to follow #March4Nutrition on Facebook, Instagram, and Twitter all month long and join the conversation. 

This #March4Nutrition, we’ll get back to basics and focus on good nutrition in the 1,000-day window. Throughout pregnancy, infancy and beyond, families need good nutrition, breastfeeding support, and nurturing care in order to thrive. 

Every week in March, we’ll dive deep into a new theme and explore how nutrition lays the foundation for brighter, healthier futures. Find more information below and check out our social media toolkit full of graphics and messages to share with your online communities!  

Week 1 March 1-8: Women’s nutrition – Access to proper nutrition can help women grow their power. 

Week 2 March 9-16: Benefits of breastfeeding – Breastfeeding has critical benefits for both moms and babies.  

Week 3 March 17-24: Healthy foods and drinks for babies and toddlers – Growing babies need good nutrition to flourish. 

Week 4 March 25-31: Raise your voice – Help us spark action to change the world for moms, babies and families, 1,000 days at a time.  

At 1,000 Days, we believe that every family, everywhere deserves the opportunity to have a healthy 1,000-day window and beyond – and that starts with access to good nutrition. 

Join us this month as we #March4Nutrition for moms and babies! 

Why Nutrition Matters

Nutrition in the First 1,000 Days – Why It Matters

Good nutrition during pregnancy and the first years of a child’s life provides the essential building blocks for brain development, healthy growth and a strong immune system. In addition, a growing body of scientific research indicates that the foundations for lifelong health—including predispositions to obesity and certain chronic diseases—are largely set during this 1,000 day period.

There are three crucial stages in the first 1,000 days: pregnancy, infancy and early childhood. During pregnancy, a mother’s health and eating habits have a significant impact on the development and future well-being of a child. If a mother’s diet is not giving her the nutrients she needs to support a healthy pregnancy and her baby’s development or if it is contributing to excessive weight gain—or both—it can have serious, long-term consequences.

From birth through the first year, breastfeeding provides unparalleled brain-building benefits and gives babies the healthiest start to life. Because of the unsurpassed benefits of breastfeeding, the world’s leading health agencies including the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend that babies are fed only breastmilk for their first 6 months, but many mothers lack the support they need to meet this recommendation.

And, finally, beginning at 6 months of age, children should eat a diverse diet of nutrient-rich foods to help fuel their growth and development and shape their taste preferences for healthy foods. Throughout early childhood, parents and other caregivers should also teach healthy eating habits and make sure that water and other non-sugar-sweetened beverages become a consistent part of a child’s diet. Deficiencies in key nutrients, poor eating habits and unhealthy weight gain during the early years of a child’s life can set the stage for numerous developmental and health problems down the road.

From India to Indiana, Kenya to Kentucky, mothers and children everywhere need good nutrition and nurturing care in the first 1,000 days to thrive. Yet too many families in the U.S. and throughout the world do not get the food, healthcare or support they need. Whether your organization works to end the crisis of malnutrition in low- and middle-income countries, or you’re focused on the urgent needs of families especially in the United States, thank you for working with us to create a healthier and more equitable future for all pregnant and birthing people, parents, and their children.