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The first 1000 days, from conception until two years of age, is such a critical period in which to build the foundations for lifelong health. Ensuring the adequate nutritional status of every mother (from pre-conception right through to breastfeeding) is essential for her health as well as for the growth and development of the child. Maternal nutritional status at conception influences trajectory fetal growth and development. Studies have shown that the nutritional status of the mother during pregnancy directly affects the overall fetal growth, organ-specific growth, physiological functioning, and fetal body composition. According to the World Health Organization (WHO), 20% of stunting (very short stature) begins in the womb.


From birth, adequate nutrition principles for the infant should be implemented and continued throughout the child’s life. The first two years of the child’s life are of particular importance as this is the period during which the child attains 50% of their adult structure and during which there is substantial brain development. Practicing regular growth monitoring from birth can assist in identifying stunting, incorrect weight for age, as well as severe and moderate acute malnutrition (SAM and MAM). Stunting is an indicator of chronic malnutrition and is directly related to poor school performance. The effects of stunting can last a lifetime and studies have shown that these children end up having lower productivity as adults and earn up to 20% lower in wages than the average adult. Stunting can reduce a country’s GDP by as much as 3%. Any deficits established during this time period are difficult to overcome beyond the child’s second birthday; hence the importance of regular screening and assessment at a very early age, before the damage is almost irreversible. A well-nourished child is better protected against disease and is more likely to perform better in school. In the long run, this will have a positive impact on society by increasing productivity and improving economic prospects for families and communities.


It is important to remember that maternal and child malnutrition does not only refer to an underweight or nutritional deficit state; it just as much refers to maternal and child overweight and obesity. Maternal obesity or excess pregnancy weight gain can lead to macrosomia (birth of a child that is large for gestational age, weighing more than 4kg at birth), altered infant glucose metabolism, and ultimately a risk of developing diabetes later in life. Rapid infant weight gain is associated with risk of obesity and chronic diseases later in life.

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