Author: Nola Martin

Maximizing Potential: The Impact of Multiple Micronutrient Supplementation (MMS) for Improved Maternal and Child Health

In the quest for improved maternal and child health and gender equality, we often overlook a fundamental intersection with the importance of good nutrition. The unique biological needs of women, gender disparities in access to food and services, and harmful social norms contribute to an ever-growing gender nutrition gap. During pregnancy, increased nutritional needs due to physical changes and the needs of a growing baby further exacerbate this gap. Micronutrient deficiencies during pregnancy put both mothers and babies at risk of birth complications, small vulnerable newborns, and even death, and the lack of nutrients in this critical period can prevent children from reaching their full physical and mental potential. Multiple Micronutrient Supplementation (MMS) during pregnancy provides a transformative solution to mitigating a wide array of harmful micronutrient deficiencies. During #March4Nutrition, we want to highlight MMS as a proven solution to meet the increased nutritional needs of women during pregnancy and further children’s growth, learning, and overall well-being.

From Cradle to Career: The Lifelong Impact of Early Nutrition on Minds and Futures

In the intricate dance of human development, the first 1,000 days emerge as a period of unparalleled significance, shaping the destinies of individuals and the key to unlocking potentials that extend far beyond childhood. During this crucial period, nutrition takes center stage, weaving a narrative that profoundly shapes not only the health and well-being of individuals but also the trajectory of entire generations. 

Cognitive Development and IQ

Scientific evidence consistently underscores the foundational role nutrition plays in cognitive development and education, making the profound impact on future generations ever clearer. A child’s brain begins to grow very early on in pregnancy and develops at an astonishing speed. At the 4th week of pregnancy, the brain has an estimated 10,000 cells—by the 24th week, it contains 10 billion. The nutrition that a baby gets from its mother through her diet is the fuel that drives much of this incredible transformation.

The occurrence of malnutrition in the first 1,000 days can hinder brain development, leading to long-term cognitive impairment. Studies show that malnutrition-related delays in cognitive development are associated with up to an 18-point reduction in expected IQ. Additionally, peers. This isn’t a just statistical figure; it translates into tangible consequences for individuals, societies, and economies.

Importantly, these differences persist from adolescence through mid-life, even for those who physically recover from malnutrition. An 18-point reduction in IQ is more than an entire standard deviation (IQ SD = 15 points), equating to a significant impact on an individual’s ability to contribute to society long-term.

Investing in nutrition during the first 1,000 days becomes a strategic move to unlock the full cognitive potential of the next generation. It’s an investment in future creators, inventors, workers, and problem solvers who can drive societal progress and innovation. The implications of this investment ripple across sectors and economies, transcending individual outcomes to shape the very fabric of a nation’s intellectual capital. 

“When you’re well nourished in your first 1,000 days, you grow taller, your brain development is better, you therefore complete more schooling and you add to your country’s economy. Across a population, this means huge shifts in better health and productivity, lifting families out of poverty, and boosting the prosperity of entire communities and nations.”

Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation

Education: The Bridge to a Brighter Tomorrow

Nutrition isn’t just about physical health; it’s a cornerstone of educational success. Well-nourished children not only exhibit better concentration and cognitive abilities but also demonstrate increased attendance and participation in educational activities. The nexus between malnutrition and educational outcomes is a critical aspect that demands our attention. Children who undergo severe malnutrition, especially during the first 1,000 days, complete an average of 4.64 fewer years of schooling than their well-nourished peers. Those who experience severe malnutrition and remain in school often face challenges, performing more poorly and taking longer to complete each grade.

Children who experience stunting, a consequence of malnutrition, score significantly lower on math and English tests, even when controlling for cognitive ability. The impact on learning processes, likely due to reduced focus and micronutrient deficiency, underscores the holistic nature of the challenge. Even mild episodes of malnutrition in utero, even in developed countries, can lead to significantly lower educational performance.

Amidst the intricate tapestry of this narrative lies a pivotal thread on gender equality. Education becomes the key for girls aspiring towards a brighter future, representing one of the most critical investments in building a world where gender equality flourishes. Each additional year of schooling not only enhances a woman’s earnings by 10-20%, but it also acts as a catalyst for achieving financial independence, gradually closing the gender-based earning gap. A stark reality persists today, with over one billion women and girls lacking access to the adequate nutrition essential for their survival and flourishing. Bridging this “gender nutrition gap” becomes not only a matter of nourishing bodies, but also of empowering minds towards a more equitable future.

The Economic Toll of Malnutrition

Malnutrition is not just a health concern; it is an economic imperative. Research from the World Bank reveals a staggering reality – individuals facing malnutrition can lose up to 10 percent of their annual earnings due to reduced education and productivity. More alarmingly, they are 33 percent less likely to escape poverty as adults. This revelation underscores the urgent need for a paradigm shift in our approach to nutrition, viewing it not only as a health intervention but as an economic driver, the key to unlocking the cycle of poverty and the lifelong consequences rooted in malnutrition.

The linkage between nutrition and future development outcomes is profound. Nutrition programming, particularly during the first 1,000 days, becomes the cornerstone for lifelong health, educational attainment, wages, and livelihoods. It is a holistic investment that not only improves individual well-being but also fortifies economies, fosters resilience to global shocks, and builds grey matter infrastructure – that is the infrastructure our children’s bodies and minds need to grow, learn, and thrive.

Investing in nutrition in the first 1,000 days is not just a moral imperative; it is a strategic move to ensure that children reach their educational potential. By addressing the root causes of malnutrition and fostering an environment conducive to learning, we pave the way for a brighter and more educated future generation that can positively impact our society and economies. As we invest in the nutrition of the youngest members of society, we are, in essence, investing in the intellectual capital of our future workforce and leaders.

In conclusion, the first 1,000 days represent a unique and invaluable opportunity to shape the trajectory of individuals, societies, and economies. Nutrition, as the linchpin connecting health, cognitive development, and education, becomes the catalyst for a brighter tomorrow. As we navigate the complexities of global development, let us recognize the transformative power of nourishment in building minds, nurturing futures, and fostering resilience in the face of global challenges. We call on everyone to join us and invest in nutrition.

World Health Organization Releases Guidelines on the Prevention of Acute Malnutrition

World Health Organization Releases Guidelines on the Prevention of Acute Malnutrition

In November 2023, the World Health Organization released updated guidelines on the prevention of acute malnutrition, also known as wasting. The guidelines followed the release of guidelines specific to the management and treatment of wasting and nutritional oedema that the organization published in July 2023.

Preventing malnutrition is key to long-term growth, development, and positive economic outcomes. Nutrition interventions, including those that prevent malnutrition, are some of the best buys in global development. Ensuring children have access to good nutrition when it matters most is one of the most powerful and cost-effective ways to create brighter, healthier futures. Leading economists consistently rank nutrition interventions among the most cost-effective ways to save and improve lives around the world with every $1 invested yielding up to $35 in economic returns.

Malnutrition continues to be one of the leading drivers of child death and disability. Malnutrition is the greatest threat to child survival worldwide and is the underlying cause of half of preventable child deaths. That is roughly 3 million children dying before their fifth birthday every year. Those who do survive severe malnutrition in early childhood are much more likely than their well-nourished peers to suffer from lifelong illnesses and disabilities.

We continue to see unprecedented rates of malnutrition and nutrition insecurity as the result of conflicts, climate shocks and stressors, and lingering impacts of the pandemic. New child malnutrition estimates from UNICEF released in May 2023 found that stunting (too short for their age) impacted 22.3% of children under 5 (148.1 million) globally and wasting (too thin for his or her height), the deadliest form of malnutrition, threatened the lives of 6.8%, or 45 million children under 5 globally.

1,000 Days welcomes the two new recommendations specific to the prevention of wasting and nutritional oedema as well as the two new good practice statements:

  • Recommendation 1: In areas of, or during times of high food insecurity, in addition to infant and young child feeding counselling, specially formulated foods (SFFs), including medium-quantity lipid-based nutrient supplements (MQ-LNS) or small-quantity lipid-based nutrient supplements (SQ-LNS), may be considered for the prevention of wasting and nutritional oedema for a limited duration for all infants and children 6-23 months of age, while continuing to enable access to adequate home diets for the whole family; and in areas of, or during times of high food insecurity, children living in the most vulnerable households should be prioritized for SFF interventions through a targeted approach. However, when targeting is not possible, these SFFs may need to be given to all households through a blanket approach for infants and children 6-23 months of age, while continuing to enable access to adequate home diets for the whole family and providing infant and young child feeding counselling. (Conditional recommendation; Grade: Low certainty evidence)
  • Recommendation 2: In contexts where wasting and nutritional oedema occur, multiple micronutrient powders (MNPs) should not be given to infants and children 6-23 months of age for the specific purpose of preventing wasting and nutritional oedema. (Strong recommendation; Grade: Moderate certainty evidence)
  • Good Practice Statement 1: In contexts where wasting and nutritional oedema occur, preventive interventions should ideally be implemented through a multisectoral and multisystem approach (i.e. food, health, safe water, sanitation and hygiene, and social protection systems). These interventions should include access to healthy diets and nutrition and medical services as appropriate, counselling (breastfeeding, health and nutrition related, especially helping families use locally available nutrient-dense foods for a healthy diet), should address maternal and family needs, and should involve psychosocial elements of care to ensure healthy growth and development.
  • Good Practice Statement 2: Infant and young child feeding counselling must be provided as part of routine care especially in contexts where wasting and nutritional oedema occur. In order for this counselling to have the most benefit for the prevention of wasting and for other child health and nutrition outcomes, personnel carrying out the counselling should have comprehensive training and be supervised regularly, with dedicated resources and time within health system strategic planning for this intervention.

In both the recommendations and in the practice statements, we were pleased to see mention of a multi-sectoral and family approach to these interventions to prevent wasting and nutritional oedema. It is key to provide access to nutritious foods and nutrition support, including breastfeeding counseling and complementary feeding, to whole families to address maternal, infant, and child nutritional needs. The guidelines note that prevention requires a package of interventions to be implemented together rather than focusing on one single intervention. We also support the recommended psychosocial elements of care to ensure healthy growth and development as preventing malnutrition early in life impacts long-term health.

These guidelines provide organizations with the tools necessary to prevent, manage, and treat malnutrition. WHO also notes that further research is needed for many of the recommendations outlined in the guidelines to be most effective in efforts to prevent and treat wasting. The guidelines provide a critical opportunity to advocate for the essential resources to support good, life-long nutrition, particularly among vulnerable populations, including those in the 1,000-day window.

Understanding Nutrition in the First 1,000 Days: Black Moms and Birthing People

To improve our advocacy and nutrition education efforts, 1,000 Days strove to understand sources of nutrition information during the first 1,000-day window and gaps in culturally relevant communications about healthy diets. Through a combination of qualitative research methods, including surveys and an environmental scan, we listened to over 225 Black pregnant and birthing people about their perceptions of their health, when and how they received nutrition information related to their pregnancy, and their preferred sources of information.