[Thorpe] Welcome to Beyond the Data.
I'm Dr. Phoebe Thorpe, and here
with me today is Lucy Sullivan the executive director
for One Thousand Days.
Hi Lucy, thank you so much for joining us.
[Sullivan] Hi Phoebe.
It's great to be here.
Thank you for having me.
[Thorpe] Our session today was about maternal infant
and childhood early childhood nutrition
and about the 1000 day window of opportunity.
What is the 1000 day window of opportunity,
and how did you get involved in it?
[Sullivan] Yes.
So the 1000 day window of opportunity refers to the time
between a woman's pregnancy and a child's second birthday.
And the reason we call it the window of opportunity is
because it's a real chance to ensure
that babies get a strong start to life.
Nutrition during that first thousand days plays a critical
role in ensuring mom and baby health
and ensuring baby's development, that they get a strong start
in terms of brain development,
and setting the foundation for lifelong health.
The 1000 day window was actually discovered if you will
by The Lancet back in 2008.
The British medical journal The Lancet
that identified this minus 9 month to 24 month window
and the role, the powerful role, that nutrition plays
in setting the trajectory for a child's health
and a child's development.
And since then, we have taken that 1000 days term and tried
to really bring greater awareness to the importance
of nutrition to ensure that every child throughout the world
and in the US gets the nutrition they need to thrive.
And for me it was a professional passion
and then became a personal passion when I became a mother.
[Thorpe] Of course.
Of course.
So let's start with the weight gain during pregnancy.
Very, nutrition is a very important part of that.
What and the amount of weight
that women gave during pregnancy is very important.
What can healthcare providers do
to help women understand the importance of that?
[Sullivan] Yeah, I'm so glad you brought that up.
Because, in the US, many women are entering pregnancy
at an unhealthy weight, and it's really important
that women start out pregnancy healthy, eating a good diet,
and obviously managing their weight.
And once a woman becomes pregnant,
it's also incredibly important to ensure
that she's gaining the appropriate amount of weight,
and this is where the healthcare providers do play a very
critical role in guiding women in terms
of the appropriate weight gain, counseling women on nutrition,
on the importance of nutrition,
and the foods they should be eating.
In this way, access to affordable,
comprehensive healthcare is critically important for women
to make sure that they have the opportunity
to see doctors during their prenatal visits and be followed
up with in terms of are they gaining the appropriate amount
of weight.
There's actually a "Goldilocks Zone" if you will
in terms of weight gain.
We want to make sure that women are gaining just the right
amount of weight, not too little and not too much,
because it's important for mom's own health
but also important for baby's health.
The amount of weight that a woman gains during pregnancy,
what she eats, her nutritional stores during pregnancy really
does have an impact on the developing child
and can set the trajectory for that child later on in life.
What's happening in that nine months in pregnancy and then
in the first few years of life really do impact a child's,
for example, predisposition to certain kinds
of chronic diseases like diabetes and heart disease.
And there is some interesting research showing
that the quality of nutrition during that 1000 day window
and the amount of weight a woman gains as part
of that really does have this this lifelong impact.
[Thorpe] So there's also plenty of research about the importance
of breast-feeding and the benefits of breast-feeding not,
and it's not just the research is not just about what
for the baby but it's for the mom both.
What can we do to help support breast-feeding more?
[Sullivan] Yeah.
I'm so glad you brought that Phoebe,
and you're absolutely right.
Breast-feeding is just as important
for mom as it is for baby.
In moms, it helps reduce the risk of breast cancer,
ovarian cancer, and high blood pressure, and so,
we want to make sure that moms have the support that they need
to get breast-feeding started.
So that means really skilled lactation support
in the hospitals, making sure that hospitals
and maternity care facilities are breast-feeding friendly,
and then that means when she goes home with the baby
that she then has the support that she needs from her partner,
from her community, certainly from her workplace
to continue breast-feeding.
One of the challenges and one of the big barriers that women have
in this country is that there is not a national paid parental
leave policy that covers all workers, and so, you have one
in four women going back to work
within two weeks of giving birth.
And it's very challenging for moms to continue to breast-feed
in accordance with the AAP recommendations and the
WHO recommendations that babies be breast-fed exclusively
for the first six months.
And then when they return to work, employers need to ensure
that there is access to lactation facilities,
so that when moms are pumping milk, they have a safe,
clean space to do so and store their milk as well.
So there's a lot more we can be doing to support mothers
to breast-feed for their own health.
And then, we haven't talked yet about the child health benefits
of breast-feeding, but it's incredibly important
as you know as a pediatrician.
And that ranges from lower infections in terms
of ear infections, respiratory infections, a lower risk
of sudden infant death syndrome which is a leading cause
of infant mortality in the US,
and so breast-feeding really is an essential public
health investment.
[Thorpe] As a pediatrician, I was delighted to hear
about the peanuts, and now there are new recommendations
to for children who are at high risk for peanut allergy
to introduce peanuts to them even as young as four months.
This is a 180 from the previous recommendations
that were given even just a few years ago,
but there are many other important things to know
about introducing foods to your young infants.
Can you tell me about some of those?
[Sullivan] Sure.
The most important thing is to introduce a variety of foods
and textures into an infant's diet, and that means fruits,
vegetables, and meats.
Meats are actually important from an iron standpoint.
Iron is a key brain building nutrient, and so,
we want to make sure that babies are getting enough iron
in their diets when they start eating solid foods.
Unfortunately, 1 in 4 1 year olds in this country 1
to 2 year olds aren't getting enough iron,
and that is certainly a concern
and something we need to be watching.
The other thing that's important is
that parents have the information that they need
to make decisions about what they should be feeding
and not feeding their babies,
and this is where I think the dietary guidelines
that are currently
under development will be incredibly helpful.
So for the first time ever,
the US government is developing a set of dietary guidelines
for pregnant women and children under two, and that is going
to be I think a really helpful source
of information for parents.
We at Thousand Days know that about half
of parents we've surveyed get mixed messages on what
to feed their baby and how to feed their baby.
So there definitely is a hunger for this kind of information.
Those dietary guidelines are also going to serve
as an important reference point for the women
and children program which is a program that serves
about half the babies born in this country,
and it's a critical program particularly for families
that that are living in food insecurity.
And we know that food insecure families, the diets tend
to be a little bit less on nutrient rich, and so,
when we think about babies and toddlers living
in low-income families, we want to make sure
that those babies are getting the wide variety of foods
that we just talked about into their diet to ensure
that they also have a strong start to life.
[Thorpe] Sure.
That makes sense.
So if people want to know more about all of these things
where would you tell them to look?
[Sullivan] So a great place to start is
of course the CDC website and the resources that CDC has
on breast-feeding and complementary feeding.
We at Thousand Days also have resources for parents
to better understand what to feed your baby,
and how to [Thorpe] When.
[Sullivan] feed your baby, when to feed your baby,
so you can check out our resources,
our website at thousanddays.org.
And then I think beyond that, the women infant
and children program the Witten program [Thorpe] Sure.
[Sullivan] that serves so many families in the United States.
They have breast-feeding counselors,
and they are a great source of advice
for nutrition information, and a great resource for parents.
So hopefully, parents can find the information that they need,
and as I said the dietary guidelines...
[Thorpe] Are coming out.
[Sullivan] Forthcoming.
[Thorpe] That's right.
[Sullivan] 2020.
[Thorpe] 2020.
[Sullivan] Will be.
[Thorpe] Posted on the web too.
[Sullivan] Yes.
[Thorpe] Yeah.
[Sullivan] A terrific resource.
[Thorpe] Lucy, thank you so much for joining us.
[Sullivan] Thank you Phoebe.
It's a pleasure being here.
[Thorpe] And thank you so much
for joining us for Beyond the Data.
We'll see you next month.