Ep. 67 The First 1,000 Days

It’s becoming more and more apparent that the first thousand days of a child’s life are crucial. In particular, the nutrition a child receives early in life dictates the kind of life that child will go on to have. But around the world, many women face huge obstacles when it comes to securing proper nutrition for their families.

Journalist Roger Thurow traveled the world to see firsthand the challenges many mothers face as a part of an exploration of a worldwide initiative to end early childhood malnutrition. He met new mothers and babies in Uganda, India, Guatemala, and Chicago, and tells their stories in the book The First Thousand Days: A Crucial Time for Mothers and Children – And the World.

Conversation Highlights

What happens when children don’t get the nutrition they need?

It’s devastating, not only for the individual child and the family, but for all of us. A lack of the nutrients, the vital minerals, nutrients and vitamins at that time, in the thousand days from when the mom becomes pregnant to the second birthday of the child, the lack of those nutrients, the lack of access to the food that provides them, results in stunting of the child. …

The brain is developing so rapidly and expansively already in this thousand-day period, and that’s all fueled by good nutrition. And so, the prolonged lack of vital micronutrients during that period can result in stunting, and stunting can be both physical or cognitive.

“Stunting” is like a horrible, harsh, ugly word- “stunting.” It’s really brusque, a rude word, but that doesn’t really convey the significance and impact of what stunting is.

The clinical definition [of stunting] is “too short for height,” but what it means for these children is it’s basically a life sentence of underachievement that’s already rendered by the time a child is two or three years old.

And you carry [the issue] throughout life; a stunted child becomes a stunted adult.

So that’s why I say that a stunted child anywhere becomes a stunted child everywhere, because when you think about it, a lost chance of greatness for a child anywhere becomes a lost chance for us everywhere because who knows what a stunted child may have accomplished for all of us, were they not stunted?

Why did you choose to feature mothers in Uganda, India, Guatemala, and Chicago?

India – with its large population, there’s more children that are born every day in India than any place else. There are more underweight children born in India then there is any place else, there are more malnourished children, there are more stunted children.

[I focused on] Uganda, because I wanted to show, the vital importance of bringing together agriculture and nutrition. So as a lay person, [you think], “Of course agriculture is nutrition, there is nutrition in the food that is being grown!” …

The moms that I followed in northern Uganda, they’ve already started then growing two new crops, orange-fleshed sweet potatoes, which are rich in Vitamin A, and then bean varieties where the Iron (which is already in the beans), but the Iron level is then is raised and elevated. Vitamin A and Iron- two extremely crucial nutrients, particularly in the first thousand days. …

And Guatemala — Guatemala has the worst childhood malnutrition stunting rates in the Western Hemisphere. It’s worse than Haiti. And in the Western highlands of Guatemala, where we followed the families, they’re largely Mayan communities. Their stunting rates upwards of 70 percent and the childhood malnutrition rates in those communities- it’s just a devastating problem.

And in Chicago, I wanted some place in the United States that would then also be able to show, “Look, these aren’t only problems over there somewhere, they’re also so critical for us.”  …

In the course of the reporting, I went back to all these places five or six times. As I would return time after time they were kind of ready to regale me with the stories [of] new things that had gone on and [to] show off- and with great pride, “Look at my children and see how they’re progressing.” (I was measuring them as it went along.)

Were there any commonalities among the mothers you met?

You know, one of the things that I found is that perhaps the most common craving of pregnant moms around the world is a craving for knowledge, particularly on food and the types of food that should be eaten, whether it’s the mom pregnant for the first time or second, third, fourth time.

[Mothers would ask me], “What can I do now? What can I do better? What can I do different for this child that I maybe hadn’t done for the others? What’s new, particularly on a nutrition front?”

[Also] I would ask the moms, and dads, “What are your ambitions for this child?” It was universal, all of them would say that their top priority, their great ambition is a good education for the child.

On changes in Guatemala where women are beginning to eat healthy sweet potatoes that were previously grown for export

A lot of the moms, they would also be working in the fields. (If the land’s not owned by the family themselves then they’d be working for other farmers.) And a vast majority … of the crops that they were growing, at least of the vegetables, would then go off to the export market. [These are the vegetables many Americans are buying in Whole Foods.]

So, here are the crops that they’re growing, the vegetables that are highly sought-after in, say, the urban markets and in [the U.S.] because of their great nutritious value, but they weren’t kept there by the farmers that are growing them because [either they] don’t have a taste for them [or]  they’re not in their diet mix. …

And so, through education and nutrition classes, [women learned],”Hey, all these crops that you’re growing  [can] be really valuable, particularly in this time for you mom, and for your child! Keep some of [the vegetables] at home, ask perhaps to be paid in these crops … here are cooking classes that you can [learn how to] incorporate them in the diet.”

… And that knowledge that some of us here may think, “Well, it should be common knowledge,” just isn’t for so many people.

There is  tremendous need in the world and you’ve also told stories of some successes. Are you optimistic?

Yeah, I am. I’m more optimistic, I guess, than when I started. As you see the moms grow in their knowledge and then the children develop, and [also] the growing momentum of the thousand days movement. … The World Bank, foundations, institutional investors, businesses, the corporate, the private sector – [are all beginning to] invest in nutrition.

The World Bank is talking about  … investments in gray-matter infrastructure – so not just bridges and roads and dams and the bricks and mortar of development, but in the gray matter, the brain development of the children that’s so important and critical and also for the growth of these economies.

And so, hopefully that momentum continues to build and … nutrition is moving out from the dark corner of development.

I mean, it’s staggering when you think that it’s less than 1 percent of all overseas development assistance money totally spent in the world is on nutrition. And you figure, “Wait a minute. Nutrition is the building block and a cornerstone of all development efforts!”