The first 1,000 days & growth monitoring and promotion (GMP)

First 1,000 days of life
 

During the first 1,000 days of life (9 months pregnancy + first 24 months of age) children grow at very high speed:

  • Children triple their weight during this period

  • Children almost double their height during this period

  • A child's brain makes millions of connections 

Why are the first 1,000 days of life so important?

  • This period is crucial for helping children to reach their potential

  • Even before birth, the fetus is at risk if the mother lacks essential nutrients needed for the brain, bone, and organ development of the baby

  • Exclusive breastfeeding in the first 6 months is the best way to ensure a healthy baby and after 6 months adding nutritious solid foods along with continued breastfeeding will support the child's brain and physical development

  • Most stunting happens in this critical period and is almost always irreversible!

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Video - the first 1,000 days explained:

Why is GMP during the first 1,000 days of life so important?
 

Measuring the height and weight of a child regularly is important to make sure the child grows and develops well:

  • The weight and height of a child can be seen and measured, but the most important growth of the brain cannot be seen

  • However, if we see that a child grows well in height we can assume that the brain also is developing well 

Video - the importance of GMP

The prevention of stunting during the first 1,000 days of life

What is stunting?

  • Stunting (low height-for-age) is a result of chronic malnutrition and frequent illness

  • Stunting is difficult to recognize as it happens gradually and stunted children are small but not necessarily too thin

  • Stunting can be reversed if detected before age 2, therefore it is very important to regularly monitor and measure children before they turn two years of age

  • Children that are stunted have high risks of getting ill, go to school fewer years than their well-nourished peers, and have lower income when they are adults. They are also at higher risk of suffering from heart disease and diabetes in adult life.

    We also know that when children do not grow well physically, their brain may also not develop as much as it should. Therefore, this is the most important reason to check children grow properly!

Video - stunting explained

Causes of stunting

Stunting is not just about a lack of food. Mothers and babies require healthy nutrition, access to health care, water and sanitation, psychosocial stimulation, and a healthy environment. 

Below are a few scenarios that increase the risk of a child being stunted:

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  • A woman does not have a healthy diet and diverse diet and therefore lacks essential nutrients 

  • A woman does not take folic acid supplementation or consumes a folic acid-rich diet before getting pregnant

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  • A woman is smoking, using drugs or alcohol during pregnancy

  • A pregnant woman has untreated health complications (such as high blood pressure, worms, tuberculosis)

  • The diet of a pregnant woman that lacks essential nutrients resulting in vitamin or mineral deficiencies (such as low iron, low folic acid/folate)

  • A pregnant woman has HIV 

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  • The mother experiences mental health problems

  • The mother stops exclusive breastfeeding before the age of 6 months

  • The baby's complementary feeding diet doesn't contain all the essential nutrients the child needs for optimal growth and development

  • The child experiences repeated infection (such as diarrhoeal disease)

  • The child has worms in the gut

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The consequences of stunting

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It is important to prevent and detect stunting within the first 1,000 days of life because actions taken after the age of two years old (24 months) are often:

  • Too late

  • Too expensive

  • Too little

  • Irreversible

Child length mat 

The child length mat can be used to early detect stunting:
- At the MindUps, a Child Length Mat which is developed based on the original design of the Manoff Group is used to early identify stunting.
- The length of a child should be measured every 3 months with the help of this child's length mat.

A child is growing well when the feet reach the green box according to the child's age!
 

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Child length mat that can be used for girls

Child length mat that can be used for boys

How to interpret the child length mat:

The child's feet are in the green zone:
The baby/child is healthy and grows according to their age.
 

The child's feet are just above the green line:
 The baby/child might be at risk of not growing according to their age. There are things that can be done to improve the growth and development of the baby/child.

The child's feet are above the green zone:
The baby/child is at risk of not growing according to their age. There are things that can be done to improve the growth and development of the baby/child.

Click on one of the buttons to see what advice and actions should be taken according to the outcome of the child length mat. 

Sources:

  1. Certa Nutritio. (2020, 1 April). GloCal Nutrition [Video]. YouTube. https://www.youtube.com/channel/UCvxwMjlLzZP_l3CvIWPZHCg

  2. Repositioning Nutrition, 2006; Lancet 2008, 2013; Growth commission, 2009

  3. World Health Organization. (2020, 29 April). Healthy diet. https://www.who.int/news-room/fact-sheets/detail/healthy-diet