Food, Nutrition, and Unit 3

Hygiene 1000 Days Nutrition

Prof. Sanjay Saxena

SMS Varanasi
Unit 3: 1000 Days Nutrition

Unit 3
1000 Days Nutrition

1.1 Concept, Requirement, Factors Affecting Growth of

Child
1. Concept and Requirement of 1,000 Days of Nutrition
The first 1,000 days refer to a child’s life from the moment they are conceived until
they have reached 2 years of age (24 months). This is a time when their brain,
body, and immune system grow and develops significantly. Good nutrition during
pregnancy and early childhood plays a foundational role in enabling a child to grow,
learn, and thrive. Nutrition is one of the most influential non-genetic factors in fetal
development.
There are three crucial stages in the first 1,000 days: pregnancy, infancy, and
toddlerhood. At each stage, during the 1,000-day window, the developing brain is
vulnerable to poor nutrition—either through the absence of key nutrients required
for proper cognitive functioning and neural connections and/or through the “toxic
stress” experienced by a young child whose family has experienced prolonged or
acute adversity caused by food insecurity.
During Pregnancy, the nutrition that a baby gets from his mother through her diet
is the indispensable fuel that drives much of this incredible transformation. Starting
in pregnancy, nutrients are needed for the creation of new neurons. When a
mother lacks adequate calories, protein, fatty acids, or key micronutrients in her
pregnancy, these vital neurodevelopmental processes can be impaired.
During infancy, the brain is developing motor functions such as balance,
coordination, and posture. This is also a critical time for hippocampal-prefrontal
connections which enable the child to create and retrieve memories. When it comes
to brain development, breastmilk is the ultimate superfood. Breastmilk contains a
variety of nutrients, growth factors, and hormones that are vital for a child’s early
brain development. Because breastmilk is a living substance with unique
components that cannot be replicated in infant formula, its impact on brain
development is unparalleled.

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In the toddler stage, a child’s brain continues to grow and develop at a rapid pace.
The speed of a child’s neural processing—that is, how quickly the brain can
interpret and relay information—also increases dramatically during early childhood,
enabling the young brain to perform more complex tasks. Food provides the fuel
for much of the extraordinary brain development that takes place in early childhood
and nutrition during this period remains critically important. In particular, protein,
iron, zinc, and iodine are essential to the toddler’s rapidly developing brain. Iron
plays a significant role in brain development throughout the first 1,000 days, and
the damage was done by iron deficiency in pregnancy and the first 2 years of a
child’s life can be irreversible.
In their first 1,000 days, babies require:
• Healthy Food
• Loving Relationships
• Safety and Security
• Time to Play
• A Healthy Environment; including in the Womb
2. Factors Affecting Growth of Child
The main factors identified in contributing to growth and development in early
childhood are nutrition, breastfeeding, complementary feeding, parent's behaviors,
parenting, stress, hygiene, etc.
Nutrition: Receiving good nutrition in the womb and through early life is essential
for a child’s future health. Research has shown that what a mother eats, her
weight, and her lifestyle habits can influence how the baby’s metabolism, immune
system, and organs’ development. Malnutrition in the mother during pregnancy,
and later in a child can cause deficiency diseases that adversely affect the growth
and development of a child. On the other hand, overeating can lead to obesity and
health problems in the long run, such as diabetes and heart disease. A balanced
diet that is rich in vitamins, minerals, proteins, carbohydrates, and fats for a mother
(before and after pregnancy), is essential for the development of the brain and
body of the child.
Breast Feeding: Another important issue in the first 1000 days that is related to
nutrition is breastfeeding. Exclusive breastfeeding is recommended for the first 6

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months of life and then continued breastfeeding along with appropriate

complementary foods for up to age 2.
Complementary Feeding: An appropriate and adequate start of complementary
feeding at six months is critical for development. In many developing countries,
children of these age groups do not receive timely, appropriate, and adequate
feeding to grow to an optimum level. Iron, iodine, and zinc are most important for
a child. Any deficiency of these nutrients during the first 1,000 days can cause
irreversible damage.
Parent’s Behavior: Smoking by mother during pregnancy or mother’s exposure
to environmental tobacco smoke has serious health consequences for both mother
and the baby. Consumption of alcohol by a mother during the first 8 months of
pregnancy may affect the behavioral and cognitive development of a child.
Parenting: Lack of personalized care during the early years of life has an
upsetting effect on the child’s health, growth, personality adjustment, and
cognitive capacity. The sensitivity and responsiveness of parents are key features
of parenting, which are positively related to a child’s health and cognitive
development. Language and cognitive development are especially important
during the first six months to three years of life. When parents are not interacting
with the child and create a less stimulating environment, then the child’s cognitive,
social, and behavioral development gets delayed. High levels of adversely and
stress during early childhood can increase the risk of stress-related diseases and
learning difficulties.
Stress: If a mother is under a lot of stress while pregnant this can affect the baby’s
nervous system and growth. This can lead to health problems later in life, including
heart disease, high blood pressure, obesity, and diabetes. Stress caused by
violence in the home can affect babies. Parents who are experiencing family
(domestic) violence may not be able to form a loving attachment with their baby.
Hygiene: Hygiene is another important thing to ensure the good growth of a child.
It is important that the mother prevents infections because if she gets ill, the child
will also be impacted. As many as two million children die every year globally due
to diarrhea caused because of lack of hygiene. All family members, including
children, need to wash their hands thoroughly with soap and water after contact

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with infectious or dirty objects. Washing hands is exceedingly important before

touching food, and before feeding children. Food, utensils, and food preparation
surfaces should be kept clean.

1.2 Prenatal Nutrition (0 – 280 Days)

Prenatal nutrition addresses nutrient recommendations to a mother before and during
pregnancy. Prenatal nutrition has a strong influence on birth weight and the further
development of the infant. Prenatal development, also called antenatal development,
in humans is the process encompassing the period from the formation of an embryo,
through the development of a fetus, to birth. Maternal nutrition plays a critical role in
fetal growth and development. It is well known that an undernourished mother
inevitably gives birth to an undernourished baby, perpetuating an intergenerational
cycle of undernutrition. Table 3.1 below includes the daily nutritional requirements for
prenatal nutrition.
Daily Nutrition Requirements
1. Protein 75 – 100 grams per day
2. Fat 40 – 90 grams per day
3. Folic Acid 60 mcg per day
4. Iron 27 mg per day
5. Calcium 1000 mg per day
6. Vitamin D 600 IU per day
7. Vitamin C 85 mg per day
8. Iodine 220 mcg per day
9. DHA 200 mg per day
Table 3.1: Prenatal Nutrition Requirements

• Protein helps in your baby’s tissue development. It develops & repairs breast and
uterine tissue, muscles, and blood during pregnancy.
• Fat gives energy and helps make your baby’s organs & placenta. Poly-unsaturated
fatty acids (PUFAs) help in a baby’s brain, nervous system, and retina development.
• Folic acid is needed for the baby’s brain and spine. Folic acid also helps make
blood during pregnancy. Enough folic acid is important in preventing neural tube
defects (NTD), a major birth defect of a baby’s brain or spine.
• Iron makes hemoglobin, a protein in red blood cells that brings oxygen to your
tissues. The amount of blood in your body increases during pregnancy, so iron is
needed for blood supply to the baby.

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• Calcium helps develop a baby’s bones, teeth, muscles, heart, and nerve function.
It is also needed for fluid control.
• Because demand for calcium increases in the third trimester of pregnancy, vitamin
D becomes crucial for fetal’s skeletal growth.
• Vitamin C is needed for wound healing and helps develop your baby’s teeth and
bones.
• Iodine helps develop your baby’s brain and nervous system. Enough iodine will
help your baby move, think, and feel.
• DHA (Docosahexaenoic acid) is needed for your baby’s brain development and
growth. It also helps you stay pregnant long enough.
Weight Gain During Pregnancy
Weight gain during pregnancy is important for the development and growth of your
baby, placenta, amniotic fluid, uterus, breasts, blood supply, and fat stores. Normal
weight gain is between 0-4 pounds during the first trimester and 1 pound per week
during the second & third trimesters.
Risk Factors During Pregnancy
But good prenatal care and support can help you minimize those risks. Following are
some factors that cause complications during pregnancy.
• Reproductive abnormalities: Structural problems in the uterus or cervix can
heighten the risk of difficulties like miscarriage, an abnormally positioned fetus,
and difficult labor.
• Women under age 20: Women under the age of 20 have a significantly higher
risk of serious medical complications related to pregnancy than those over 20.
Teenage mothers are more likely to deliver prematurely, have a baby with low-
birth-weight experience pregnancy-induced hypertension, or develop
preeclampsia.
• Women over age 35: Older women are more likely to have conditions like high
blood pressure, diabetes, or cardiovascular disease that can complicate pregnancy.
When these conditions aren’t well controlled, they can contribute to miscarriage,
poor fetal growth, and birth defects.
• Weight: Being either overweight or underweight can lead to complications during
pregnancy.

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• Obesity: Women who are obese are at a higher risk than normal-weight women
of having babies with certain birth defects, including spina bifida, heart problems,
hydrocephaly, or cleft palate and lip.
• High blood pressure: Pregnant women with chronic high blood pressure are at
an increased risk for a low-birth-weight infant, preterm delivery, kidney damage,
and preeclampsia during pregnancy.
• Autoimmune Disease: Women with an autoimmune disease may be at a risk for
premature delivery.
• Thyroid Disease: Hyperthyroidism (overactive thyroid) or hypothyroidism
(underactive thyroid) that is not controlled can lead to heart failure or poor weight
gain in the fetus as well as birth defects.
• Uterine Fibroids: While uterine fibroids can be relatively common, they can cause
miscarriage and premature delivery in rare cases.

1.1. Breastfeeding
Breastfeeding is when you feed your baby with breastmilk, usually directly from your
breast. It is also called nursing. Nursing can be a wonderful experience for both mother
and baby. It provides ideal nourishment and a special bonding experience that many
mothers cherish. Breastmilk is the ideal food for infants. It is safe, clean, and contains
antibodies that help protect against many common childhood illnesses. Breastmilk
provides all the energy and nutrients that the infant needs for the first months of life,
and it continues to provide up to half or more of a child’s nutritional needs during the
second half of the first year, and up to one third during the second year of life.
Breastfed children perform better on intelligence tests, are less likely to be overweight
or obese, and are less prone to diabetes later in life. Women who breastfeed also have
a reduced risk of breast and ovarian cancers.
Breastmilk is also called as "perfect food" for a human baby's digestive system.
Breastmilk's components such as lactose, protein (whey and casein), fat, and
carbohydrates are easily digested by a newborn. Breast milk also naturally contains
many of the vitamins and minerals that a newborn requires.
It is recommended to practice exclusive breastfeeding for the first six months of life
and that breastfeeding continues for at least 12 months. A diet of exclusive breast

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milk is recommended for the first 6 months of life followed by the addition of solid
foods plus breastmilk for up to 2 years of age.

1.2. Formula Feeding

Commercially prepared infant formulas are a nutritious alternative to breastmilk, and
even contain some vitamins and nutrients that breastfed babies need to get from
supplements. Manufactured under sterile conditions, commercial formulas attempt to
duplicate mother's milk using a complex combination of proteins, sugars, fats, and
vitamins that are not possible to create at home. The formula is a nutritionally
complete food for babies. Many formula products contain extra ingredients so that
they more closely match breastmilk. One of the main differences between formula
and breastmilk is that breastmilk contains antibodies, which help protect the baby
against a range of illnesses.
In the market, infant formulas are available in three forms, which are powered form,
concentrated liquid form, and ready-to-use form. Formulas are basically two types:
Milk-based formula, which is prepared from cow milk with added vegetable oils,
vitamins, minerals, and iron. Soy-based formula, which is made from soy protein with
added vegetable oils (for fat calories) and corn syrup and/or sucrose. These formulas
are suitable for infants who cannot tolerate lactose (lactose intolerant) in the milk-
based formula.

1.3. Complementary and Early Diet (6 Months – 2 Years

of Age)
Complementary foods are defined by the WHO as any food or liquid other than
breastmilk. World Health Organization recommends that infants start receiving
complementary foods at 6 months of age in addition to breast milk. Initially, they
should receive complementary foods 2-3 times a day between 6-8 months, which
should be increased to 3-4 times daily between 9-24 months. period. Good
complementary foods are rich in energy, protein, and micronutrients (particularly iron,
zinc, calcium, vitamin A, vitamin C, and folate) and they are not spicy or salty.
Table 3.2. is showing a sample menu for babies at the age 6 to 7 months:

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Timing Menu
• Baby cereal (1 tablespoon) mixed with breastmilk or
formula
Breakfast • Mashed fruit (1/2 tablespoon)
• Yogurt (1/2 tablespoon)
• Breastmilk or 100mL infant formula
Mid-Morning • Breastmilk or 150mL infant formula
• Blended/mashed meat (1 tablespoon)
• Blended/mashed vegetables (1 tablespoon)
Lunch • Bread cut into pieces (1/2 slice) or pasta/rice (1
tablespoon)
• Breastmilk or 100mL infant formula
Mid-Afternoon • Breastmilk or 150mL infant formula
• Blended/mashed meat (1 tablespoon)
Dinner • Blended/mashed vegetables (1 tablespoon)
• Pasta/rice (1 tablespoon)
• Breastmilk or 100mL infant formula
Table 3.2: Sample Menu (6 - 7 Months)

Table 3.3. is showing a sample menu for babies at the age 7 to 12 months:
Timing Menu
• Baby cereal (about 3 tablespoons) mixed with
breastmilk or formula or cow’s milk
Breakfast • Mashed fruit (1 tablespoon)
• Yoghurt (1/2 tablespoon)
• Breastmilk or 100mL infant formula
Mid-Morning • Breastmilk or 150mL infant formula
• Blended/mashed meat (1 tablespoon)
• Blended/mashed vegetables (1 tablespoon)
Lunch • Bread cut into pieces (1/2 slice) or pasta/rice (1/4 cup)
• Breastmilk or 100mL infant formula
Mid-Afternoon • Breastmilk or 150mL infant formula
• Blended/mashed meat (1 tablespoon)
Dinner • Blended/mashed vegetables (1 tablespoon)
• Pasta/rice (1/2 cup)
• Breastmilk or 100mL infant formula
Table 3.3: Sample Menu (7 - 12 Months)

At the age of 1 year, the child can eat all solid food. At this age, the infant becomes
capable of eating all the foods that are cooked for the family, such as rice, lentils,
vegetables, roti, fish. The child should gradually try to inculcate the habit of eating
according to the family diet, because by the age of one year the child is able to eat
and digest many foods.

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References
1. Bansal. R. (2021). Food, Nutrition, and Hygiene, SBPD Publishing House, Agra,
India.
2. Singh. Anita. (2018). Food and Nutrition. Star Publications, Agra, India.
3. https://familydoctor.org/changing-your-diet-choosing-nutrient-rich-foods/
4. https://www.healthline.com/health/food-nutrition/six-essential-nutrients
5. https://www.foodstandards.gov.scot/consumers/healthy-eating/nutrition/the-
five-food-groups
6. https://www.brainkart.com/article/Functions-of-food_33938/
7. http://conditions.health.qld.gov.au/HealthCondition/condition/8/78/412/introduci
ng-complementary-foods-feeding-from