Category: Nutrition

1,000 Days Statement on Increased U.S. Infant Mortality Rates

At 1,000 Days, we are deeply concerned by the recent CDC data revealing an increase in infant mortality in the United States for the first time in two decades. Our nation has one of the highest infant and maternal mortality rates of any wealthy country. This disheartening increase is a stark reminder of the urgent need for collective action to address the critical challenges facing maternal and child health in the United States.

The CDC found that the overall infant mortality rate increased by 3% with significant increases for mothers aged 25-29. Mortality rates also climbed for preterm babies, male infants, and for infants born in Georgia, Iowa, Missouri and Texas. The data also shows a deepening divide along racial and ethnic lines with infant mortality rates for American Indian or Alaska Native women increasing by over 20%, from 7.4 deaths to over 9 deaths per 1,000 births, while rates for White women increased by about 3% from 4.36 deaths to 4.52 deaths per 1,000 births. Infant mortality rates for infants of Black women did not drastically increase but they continue to experience the highest overall rates of mortality with nearly 11 deaths per 1,000 births, or over double the mortality rate of White infants. The significant disparities in infant mortality rates among different racial groups highlight the pervasive impact of systemic inequities on health outcomes.

1,000 Days remains dedicated to our mission of making the health and well-being of women and children in the first 1,000 days, from pregnancy to two years of age, a policy and funding priority. We call on Congress to continue investing in maternal and child health and services, recognizing that it is critical during the 1,000-day window to deliver nutrition and support for women and infants. Access to proper nutrition and comprehensive maternal health services is a right for all women and families, and it is imperative to ensure that no one is left behind. Strong policies and investments in this critical window are not only about saving lives today but also about nurturing healthier generations.

A strong start in life is every child’s right, and we are committed to working alongside partners, communities, and policymakers to create a world where all children can thrive. The CDC’s findings reinforce the urgency of our mission, and we stand ready to collaborate and advocate for the changes needed to ensure better outcomes for everyone.

Together, we can strive for a future where infant mortality is a rare and unacceptable tragedy. Join us in making a difference and securing a brighter future for the next generation.

For more insights and information, please visit the CDC report here.

World Food Day 2023 Highlights an Opportunity for the US to Lead on Preventing & Treating Malnutrition

World Food Day 2023 looks similar to recent past food days as the world continues to grapple with high rates of food and nutrition insecurity due to long lasting impacts of the pandemic, climate shocks and stressors, conflict, and inflation. Although much attention has been paid to rising rates of malnutrition, unfortunately, in 2023, malnutrition continues to impact tens of millions of children around the world. New child malnutrition estimates from UNICEF released in May 2023 found that stunting impacted 22.3% or 148.1 million children under 5 globally and wasting threatened the lives of 6.8%, or 45 million children under 5 globally.

To meet the Sustainable Development Goals related to food security and nutrition, targeted interventions and significant investments must be made to reverse the current malnutrition trends and speed up progress. Due to the compounding crises impacting malnutrition, it is estimated that to stay on track with reaching global nutrition targets, at least $10.8 billion each year from 2022 to 2030 is needed.

A new study published just last week in The Lancet shows how dire nutrition needs are, specifically within the 1,000-day window. These new data from WHO, UNICEF, and the London School of Hygiene and Tropical Medicine found that 1 in 10 babies worldwide are born early, with major impacts on health, survival, and eventual economic impact. Since prematurity is the leading cause of death in children’s early years, there is an urgent need to strengthen prenatal care for mothers that protect both mom and baby, focus on malnutrition prevention in early life, and provide postpartum care that nurtures mom and supports breastfeeding.

In addition to the efforts to treat malnutrition, further attention should be paid to prevention of malnutrition in the first place. Over the last year, USAID has not only released the implementation plan for the Global Malnutrition Prevention and Treatment Act (GMPTA), but also released a position paper on child wasting in June 2023 which outlined specific, actionable steps on how the USG will continue its investments and commitments to reduce and prevent malnutrition globally. Some of these steps include: strengthening nutrition as part of primary health care, building a better understanding of the specific pathways through which food systems can most effectively and efficiently prevent child wasting, improving access to RUTF for treatment and SNFs for prevention, supporting the development of sustainable financing strategies for health systems and the procurement of SNFs, and conducting joint cross-sectional and cross-bureau analyses and/or implementation research in nutrition priority countries.  

Necessary investments would help to close the nutrition insecurity gaps seen in the most vulnerable populations, including women and children. Our advocacy community continues to seek additional monetary investments from the US Government to improve nutrition security. Malnutrition is the underlying cause of nearly half of all childhood deaths under 5, however, it only received under 1.5% of US global health funding in FY2023 while AIDS, malaria, and tuberculosis collectively netted roughly 72%. For FY24 funding requests, our global nutrition advocacy community requested $300M for the nutrition sub-account which would save the lives of 30,303 children annually according to the World Bank’s Nutrition Investment Framework. Efforts to reduce funding for this account undermine progress made to address malnutrition and will put lives at risk.

As Congress continues to draft FY24 appropriations bills ahead of the November 17th continuing resolution deadline, we urge them to protect and defend investments aimed at improving the health and nutrition of vulnerable populations, like women and children, particularly in the first 1,000 days. In addition, FY25 budgets and appropriations bill should include investments that both prioritize preventing and treating malnutrition. To accelerate progress on preventing and treating malnutrition, Congress and the US Government must solidify their role as a leader in putting health and nutrition first.

Nutrition is a Feminist Issue

Nutrition only featured in three of the 75+ sessions and events of the Women Deliver conference which brought over 6,0000 advocates, activists and decisionmakers to Kigali, Rwanda, last week. But what Women Deliver demonstrated is that nutrition is part of a much bigger framework, and an integral component of the feminist agenda. Here are three reasons why maternal nutrition is a feminist issue:

  1. The gender nutrition gap is real, widening, and solvable:  It is the political failure to meet the unique nutritional needs of women and girls and ensure their access to nutritious diets, nutrition services, and nutrition care. More than 1 billion adolescent girls and women worldwide suffer from undernutrition, including detrimental lifelong effects of the consequences of wasting and stunting, micronutrient deficiencies, and anaemia, according to UNICEF’s Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women report. Malnourished mothers give birth to small and vulnerable newborns with immediate and long-term consequences for individual and societal development and growth. Today, approximately 20 million infants are born with low birthweight globally.  Cultural norms, social roles, economic disparities, and discriminatory practices create and sustain this gender nutrition gap. 1,000 Days was among 40+ organizations to launch Closing the Gender Nutrition Gap: An Action Agenda for Women and Girls. It aims to unite stakeholders in the nutrition, health and gender communities to take specific actions that improve women’s and girls’ nutrition while advancing maternal, newborn and child health and gender equality. The Action Agenda prioritizes actions for healthy diets, access to healthcare and social protection, gender equality and creating an enabling policy environment.
  • Adequate nutrition and breastfeeding are part of a woman’s right to bodily autonomy,  which UNFPA defines as  ‘the power and agency of individuals to make choices about their bodies without fear, violence or coercion’. While the concept is often used to advocate for reproductive justice, it goes beyond sexual and reproductive health and services and encompasses access to the wide range of care and services necessary to keep our bodies, minds and spirits healthy and whole – including nutrition – as per the Positive Women’s Network framework. UNFPA announced the Kigali Call to Action: United for Women and Girls’ Bodily Autonomy  for accelerated investments and actions, with women-led organizations and the feminist movement at the centre. Bodily autonomy is a strong platform to call for the right to breastfeed, as well as access to diverse and nutritious foods for all pregnant and lactating women, babies and toddlers. It is also a powerful aggregator to build a solidarity front against regressive forces. 
  • Maternal health is divisive and divided: As advocates calling attention on specific aspects of a woman’s health and wellbeing, we risk positioning women as a set of issues to be solved and competing for attention and space.  This does not only diminish our voice and reduce our impact, but it also leaves a vacuum for the opposition to fill, with clear, unified anti women’s rights messages.  Calling for reproductive justice, access to antenatal care, newborn and child health, respectful care, nutrition services, exclusive breastfeeding are not competing agendas, but all contribute to redressing the systemic inequalities that women face and that prevent them from reaching their full potential. Feminism, as a social justice movement, provides a larger and stronger platform to join forces and advance women’s nutrition, including nutrition for pregnant and lactating women.

Senate FY24 Agriculture Appropriations Bill Prioritizes Nutrition for Children and Families

1,000 Days commends the Senate Committee on Appropriations for prioritizing families in need both domestically and globally in their FY24 Agriculture Appropriations bill. In contrast to the House version, the Senate’s proposed bill-based funding on levels agreed to in the debt ceiling deal reached earlier this month is a superior starting point. Of note, the Senate’s bill funds the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) at $6.3 billion, maintaining current food package benefits and participation levels. The bill also acknowledges the importance of global nutrition programs through funding for international food assistance programs. It provides $1.8 billion in funding for Food for Peace, Title II programs and $248.3 million for the McGovern-Dole International Food for Education and Child Nutrition programs, maintaining enacted levels from FY2023. These programs can improve nutrition within the 1,000-day window through evidence-based nutrition interventions. At a time when stunting is impacting 148 million children under 5 globally and wasting is threatening the lives of 45 million children, it is critical that investments meet the moment to reverse the trend of increasing rates of malnutrition. With malnutrition costing the world $3.5 trillion in lost productivity and healthcare costs annually, Congress has the ability to change the trajectory of malnutrition which impacts current and future generations.

How well, or how poorly, mothers and children are nourished and cared for during the 1,000-day window has a profound impact on a child’s ability to grow, learn and thrive. The Senate’s bill invests in federal programs that can significantly improve nutritional outcomes during this vital period of development for children. As the appropriations process moves forward, we urge Congress to base final funding decisions on the Senate proposal, helping families both domestically and internationally to have access to nutritious foods and services.

Bills We are Watching this Children’s Week

As we kick off the 2023 Children’s Week, we feel a mixture of excitement for the opportunities to improve children’s nutrition and concern about policy and funding proposals that undo progress to protect the health and wellbeing of children and their families in their 1,000-day window.

The nutrition that people receive leading up to and throughout their pregnancy, as well as the nutrition their babies receive in the earliest years of life, has a profound impact on a child’s ability to grow, learn, and thrive. In honor of Children’s Week, 1,000 Days is highlighting some legislation that we support focused on children, mothers, and birthing people. It is our hope that with these bills enacted, moms, babies, and their families will receive the support and resources they need to begin to build a healthier future.

The Wise Investment in Children Act of 2023 (WIC Act of 2023) (H.R.3364/S.1604) expands eligibility to receive benefits under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This would extend the certification period for infants to up to two years and increases the certification time under the program for postpartum women to a period of up to two years.

Modern WIC Act of 2023 (H.R.2424/S.984) would build on lessons learned during the pandemic and modernize WIC to allow remote access. The remote flexibility implemented during the public emergency contributed to a 12% increase in child participation since 2020.

WIC Healthy Beginnings Act (H.R.3151/S.974) requires USDA to make information on infant formula procurement under WIC publicly available. This increases transparency and promotes competition within the sole-supplier model.

Black Maternal Health Momnibus Act (H.R.3305/S.1606) will address the maternal mortality crisis in the U.S. through historic investments that comprehensively address every driver of maternal mortality, morbidity, and disparities in the United States. The Momnibus Act includes twelve individual bills that among other actions will make critical investments in social determinants of health that influence maternal health outcomes, like housing, transportation, and nutrition and extend WIC eligibility in the postpartum and breastfeeding periods.

The Family Act (H.R.3481) would provide employees a family and medical leave insurance monthly benefit payment of two-thirds of the employee’s regular pay, limited to a maximum of $4,000, for no more than 60 days of qualified caregiving. The bill also established the Office of Paid Family and Medical Leave within the Social Security Administration.

No Surprise Bills for New Moms Act (H.R.3387) would automatically cover newborns with health insurance for the first 30 days and create a standard for enrollment after that period. It eliminates confusion for new parents by establishing a uniform 60-day enrollment period after that first month. The bill would also have all health plans and insurers notify parents if they receive a bill for an uncovered newborn.

We also continue to remain focused and engaged in the appropriations process for FY2024. Non-defense discretionary programs, which disproportionately serve young children, families, and those most in need across the country, will face the brunt of spending caps and cuts. We must protect programs that support children and families and build off the recent successful increased investments in the first 1,000 days. In doing so, we are letting our children and our nation’s future the opportunity to thrive. How well or how poorly mothers and children are nourished and cared for during the 1,000-day window has a profound impact on a child’s ability to grow, learn and thrive.

House FY24 Agriculture Appropriations Bill will Stall Progress, Decrease Access for Families in Need

1,000 Days is dismayed by the House Appropriations Committee’s fiscal year 2024 Agriculture Appropriations bill released today. This bill under delivers in providing nutrition assistance to those in need and rolls back successful program improvements implemented during the pandemic. Of concern, the bill would reduce funding levels for WIC below current levels, with proposed funding $800 million below the FY24 President’s Budget request. This would result in fewer women and children being served, and possible waitlists for those that qualify for the program. The proposed House Agriculture Appropriations bill ends the increased fruit and vegetable benefits that have been provided to families since April 2021, further reducing nutrition benefits provided to WIC participants. These benefits have had multiple benefits, especially for young children, including increased fruit and vegetable consumption in WIC toddlers and a broader variety of fruit and vegetable purchases by parents. The bill also undermines the science-based review process for the WIC food package, preventing USDA from updating the foods provided to include more fruits, vegetables, seafood, and whole grains.

The proposed bill is short-sighted, cutting benefits to pregnant women, infants and children when investment in the 1,000 days between pregnancy and a child’s 2nd birthday sets the foundation for all the days that follow. How well or how poorly mothers and children are nourished and cared for during the 1,000-day window has a profound impact on a child’s ability to grow, learn and thrive. Research has proven that WIC saves lives. WIC reduces fetal deaths and infant mortality; reduces low birthweight rates and increases the duration of pregnancy; and it improves the growth of nutritionally at-risk infants and children. We call on Congress to fund WIC at $6.35 billion in fiscal year 2024, providing essential nutrition services during this critical timeframe.

Lifting Up the Powerful Role of Nutrition for Policymakers and Advocates

Good nutrition before, during, and after pregnancy has a profound impact on the health of both a mother and child. This National Nutrition Month (NNM), and as part of our global #March4Nutrition campaign, 1,000 Days is highlighting some of the nutrition-related regulations and legislation that we support to ensure every child can grow, learn, and thrive. Much of this legislation also shapes the future for mothers, pregnant, birthing and postpartum people. This Spring, we are focused on advocating for regulatory updates, legislation that supports nutrition for families here in the U.S. and around the world, and additional funding to support all these programs. This year’s NNM theme of “Fuel for the Future” highlights the importance of ensuring families are well nourished to support healthy futures.

Updated Regulations for Maternal & Child Nutrition

WIC Food Package Updates

The United States Department of Agriculture (USDA) has proposed several regulatory changes to strengthen nutrition programs and improve maternal and child nutrition. The agency is currently updating the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages, that would impact over 6 million WIC participants which include moms, babies, and young children. The updates, which are science-based and align with the most recent Dietary Guidelines for Americans and the 2017 National Academies (NASEM) report, increase fruit and vegetable vouchers, promote greater flexibility to accommodate cultural food preferences and dietary needs, strengthen support for breastfeeding, and increase access to under-consumed, nutritious foods, like seafood with lower levels of methylmercury.

Child Nutrition Program Updates

USDA also proposed updated nutrition standards to school meals that would more closely align the standards recommended in the Dietary Guidelines for Americans to provide children with nutritious and delicious meals. The proposed updates do include some changes to the Child and Adult Care Food Program (CACFP), which serves young children, including those in their 1,000-day window, at childcare. Changes in the CACFP program would support more nutritious meals and snacks by reducing added sugar content and allowing more plant-based meat/meat alternate options.

Dietary Guidelines for Americans

While not specific legislation or regulations, the Dietary Guidelines for Americans (DGA) form the basis of nutrition policy in the U.S. and are a critical component of improving maternal and child nutrition. Co-developed every five years by USDA and the Department of Health & Human Services (HHS), the basis of the guidelines is a science-based report developed by the Dietary Guidelines for Americans Advisory Committee (DGAC) which includes nutrition researchers, physicians, and Registered Dietitians. The DGAs have a broad impact ranging from WIC food packages and child nutrition programs to food labeling and nutrition education programs. The guidelines include dietary recommendations for pregnant and lactating people and birth to age 2, which were included for the first time in the 2020-2025 DGA. The next iteration of the guidelines is currently underway as the DGAC is reviewing evidence and drafting conclusion statements which will ultimately lead to dietary recommendations and guidelines for Americans, including mothers, babies, and young children.

2023 Farm Bill

Every five years, Congress reauthorizes the Farm Bill which is a robust, multiyear law that authorizes food and agricultural programs. Although the name may imply that most of the bill is focused on farming and agriculture, nutrition spending makes up an overwhelming majority of the legislation. In 2018, the nutrition title (Title IV) made up about 76% of total Farm Bill spending, and for the 2023 Farm Bill, it is projected to be as much as 85%. The Supplemental Nutrition Assistance Program (SNAP), formerly known as “food stamps,” is authorized in the Farm Bill which is the reason for the large amount of spending for nutrition in the bill. When children have access to SNAP, from birth through early childhood, their risk of developing high blood pressure, heart disease, diabetes, and other poor health outcomes later in life greatly decreases. Children on SNAP can immediately experience a reduction in food insecurity. As Congress works to reauthorize the 2023 Farm Bill, it is imperative that they ensure families have access to the food and nutrition assistance they need through SNAP benefits as nearly half of all people who participate in SNAP are children.

In addition to domestic nutrition programs, the Farm Bill also reauthorizes international food aid programs in Title III. These programs include Food for Peace Title II, the McGovern-Dole Food for Education Program, Food for Progress, and the Bill Emerson Humanitarian Trust. These programs are primarily focused on improving food security. As Congress works to reauthorize the 2023 Farm Bill, we urge them to further consider how the programs can incorporate nutrition interventions to address both food and nutrition insecurity and prevent malnutrition. Robust funding will be needed to address the current malnutrition crisis and to build resilience in communities globally.

Implementation of the Global Malnutrition Prevention & Treatment Act

In October 2022, the Global Malnutrition Prevention & Treatment Act (GMPTA) was signed into law to bolster the federal government’s efforts to address global malnutrition and build resilience. It authorizes the United States Agency for International Development (USAID) to advance targeted interventions to prevent and treat malnutrition around the world while requiring a robust monitoring of interventions to ensure effective use of funding. As USAID works to draft the implementation plan and coordinate efforts, we look forward to working alongside them to ensure all activities address the nutritional needs of families in their first 1,000 days.

Fiscal Year 2024 Appropriations

Addressing nutrition security in the U.S. remains a critical need. 1,000 Days joins the National WIC Association and the broader maternal and child health community in urging funding of $6.35 billion for WIC in FY 2024. This amount will ensure adequate funding to support WIC’s growing caseload and address rising food costs in WIC food categories. We also support increased funding to strengthen FDA’s food safety and nutrition capacity, especially for infants and young children.

While reductions in global mortality rates for women and children are two of the biggest success stories in international development, progress has slowed over the past 12 years. There remain significant gaps that additional investments can help close. In 2021, 5 million children under age five died from mainly preventable and treatable diseases, with malnutrition as the underlying cause of roughly half of these deaths. Additionally, 300,000 women die annually of preventable causes related to pregnancy and childbirth. 

As Congress determines funding levels for FY2024, it is critical that funding meets the moment to address the malnutrition crisis. 1,000 Days as part of the 1,000 Days Advocacy Working Group (AWG) and the Maternal, Newborn, Child Health Roundtable (MNCH RT), is requesting $300 million for the nutrition account and $1.15 billion for the maternal and child health (MCH) account within USAID. Malnutrition costs the world $3.5 trillion in lost productivity and healthcare costs each year. The current global food crisis, fueled by conflict, climate shocks and the threat of a global recession, continues to threaten the lives of women and children globally. Full funding of the nutrition account is critical for saving lives and reaching USAID’s goal of ending preventable child and maternal deaths.

President’s FY2024 Budget Meets the Moment for U.S. Families, Misses the Mark for Foreign Investments in Nutrition

The Biden Administration’s FY 2024 budget proposal includes significant funding for several of 1,000 Days’ domestic key policy priorities. The proposal reflects priorities of the 2022 White House Conference on Hunger, Nutrition, and Health and opportunities identified in the American Journal of Public Health series to unlock the untapped potential of this critical time by closing data gaps, enhancing promising programs, strengthening policies and uniting around this powerful window of growth. It includes:

  • $6.3 billion to fully fund the 6.5 million individuals expected to participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
  • $325 million to establish a national, comprehensive paid family and medical leave program plus $10 million to help states expand access to paid leave benefits, including creation of a Technical Assistance Hub to share best practices among states.
  • $471 million to support implementation of the White House Blueprint for Addressing the Maternal Health Crisis to strengthen maternal health initiatives. Additionally, the budget requires all states to provide continuous Medicaid coverage for 12 months postpartum, eliminating gaps in health insurance at a critical time.
  • Increased funding for early care and education programs to increase childcare options for more than 16 million young children and lower costs so that parents can afford to send their children to high-quality child care.

While we celebrate increases across domestic nutrition programs, the proposals for global programs missed the mark. We welcome the topline increases for the State Department and USAID, but the Administration’s proposal to provide no increases to current investments in global nutrition and maternal & child health fall short in addressing growing the need. This past week, a report released from UNICEF shed light on how dire the malnutrition crisis is, particularly among adolescent girls and women. The number of pregnant and breastfeeding mothers suffering from acute malnutrition has soared from 5.5 million to 6.9 million – or 25 percent – since 2020 in 12 countries hardest hit by the global food and nutrition crisis. 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.

As rates of hunger and malnutrition continue to climb around the globe, it was disappointing to see that Global Health accounts within the United States Agency for International Development’s (USAID) budget for the Nutrition and Maternal & Child Health (MCH) did not receive funding increases in the President’s Fiscal Year 2024 budget. Within the proposal, the nutrition account is flat funded at $160 million and the MCH account is flat funded at $910 million. The NGO community has called for no less than $300 million for the nutrition account and $1.15 billion for the MCH account. The released budget is world’s apart from these needs-based community asks to address the ongoing health and nutrition crisis.

Ultimately, these funding levels will be decided by Congress and we urge Congress to fund State and Foreign Operations accounts at a level that meets the moment, including $300 million for the Global Health Nutrition account, $1.15 billion for the Maternal and Child Health account.

Our favorite time of year: #March4Nutrition

Our favorite time of year: #March4Nutrition

We’re thrilled to celebrate the 50th anniversary of National Nutrition Month in March 2023. Developed by our friends and colleagues at the Academy of Nutrition and Dietetics, every March we work especially to amplify the importance of nutrition for families in the first 1,000 days: the time between pregnancy and a baby’s second birthday.

Throughout pregnancy, infancy and beyond, families need good nutrition, breastfeeding support, and nurturing care in order to thrive. Backed by decades of research and most recently the American Journal of Public Health’s special nutrition series, we know nutrition plays a foundational role in a child’s development and her country’s ability to prosper.

We invite you to follow #March4Nutrition on Facebook, Instagram, and Twitter all month long and join the conversation. Every week in March, we’ll dive deep into a new theme and explore how nutrition lays the foundation for brighter, healthier futures.

Week 1 March 1-10: Women’s nutrition – Access to proper nutrition can help women grow their power.

Week 2 March 13-17: Benefits of breastfeeding – Breastfeeding has critical benefits for both moms and babies.

Week 3 March 20-24: Healthy foods and drinks for babies and toddlers – Growing babies need good nutrition to flourish.

Week 4 March 27-31: Raise your voices – 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!

New Series in the American Journal of Public Health Identifies 1,000-Day Window as Untapped Potential to Improve Health of Families

Opportunities, Challenges Identified for Pregnant People and Babies 0-2

(WASHINGTON D.C.) Over the last two decades, science has shown that the 1,000-day window, the time between a pregnancy and the baby’s second birthday, is most critical for brain development and when good nutrition has the greatest influence on future health. Today, on the heels of the first White House Conference on Hunger, Nutrition, and Health in more than 50 years, The American Journal of Public Health released a special series that identifies opportunities to unlock the untapped potential of this critical time by closing data gaps, enhancing promising programs, strengthening policies and uniting around this powerful window of growth.

“Prioritizing the health of babies, younger children, and mothers will reap significant returns on investment, setting the foundation for the health of our nation,” said Ambassador Susan Rice, White House Domestic Policy Advisor, in one of the editorials in the series. “Everyone has a role to play—the private sector; state, local, tribal, and territory governments; civil society; academia; philanthropy; and other partners.”

The 70-page series with more than 15 authors outlines the role of Early Childcare and Education (ECE) settings to strengthen overall support systems for low-income families and influence the healthy growth and development of children; how to improve breastfeeding outcomes without leaving anyone behind; new analysis on COVID’s impact for people who gave birth during the height of the pandemic; investments needed to achieve nutrition security; and new opportunities for pediatricians to better support families in their care with nutrition advice and access.

“This special issue sets the stage for what we know about nutrition in the first 1,000 days in the U.S. and what is needed to move forward. Unfortunately, nutritious foods are not uniformly and equally available to all. This has unique relevance to the first 1,000 days as inequities in childhood growth and development due to poor nutrition can have long-term effects on cognitive development and health throughout that child’s life,” said Dr. Ruth Petersen, MD, MPH, Director of the Division of Nutrition, Physical Activity and Obesity at the Centers for Disease Control and Prevention (CDC), guest editor of the series and an author (R. Petersen).  The series identifies:

  • Gaps in data of nutrition status and eating behaviors through pregnancy, infancy and toddlerhood (H. Hamner), including micronutrient deficiencies such as iron status, which leaves women vulnerable to poor maternal outcomes (M.E. Jefferds).
  • Steps to improve nutrition of pregnant people, including how to realize the potential benefits of breastfeeding so no one is left behind (R. Perez-Escamilla).
  • Impacts of early disparities from historically underserved communities, especially racial disparities that stem from systemic racism in food access, education, housing, health care and employment that have been exacerbated by the COVID-19 pandemic (S. Bleich).
  • Efforts to counter repeated exposure of marketing of unhealthy foods and drinks (J. Harris),  and address overconsumption of ultra-processed food through government policies (J. Krieger).
  •  Opportunities to leverage federal and state programs and policies, such as ECE funding streams, state licensing regulations, state quality improvement programs, and accrediting organizations to strengthen nutrition security in childcare settings. (C. Dooyema).
  • Actions key sectors can take immediately, including childcare, healthcare and the philanthropic sector, as well as policy recommendations for the U.S. government (B. Thomas).  

“What happens in the first 1,000 days sets the foundation for every day that follows. How well or how poorly mothers and children are nourished and cared for during this time has a profound impact on a child’s ability to grow, learn and thrive,” said Blythe Thomas, initiative director of 1,000 Days, an initiative of FHI Solutions. “Achieving nutrition security during the first 1,000 days will ultimately require multisector collaboration, advocacy, and action to fully support families where they live, learn, work, play, and gather. We invite all to join us in prioritizing and realizing the opportunity presented by this AJPH supplement.”

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