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Other Articles (Non CPD Accredited): General Healthcare

The first 1000 days of life

‘It’s easier to build strong children than repair broken men,’ these words of wisdom by American defender of human rights and social reformer Frederick Douglass, drive home the key message of this article and speak truly to the concept of preventing illness rather than reacting to it once it is already present.

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As a parent, it goes without saying that one always wants what’s best for your child, we do our best to provide a loving, secure home, the best education, lovely clothes, toys and all the little things that make them happy. These are some of the things we prioritise when we are blessed with children and rightly so. However, what if I told you that one of the greatest priorities, one of the greatest gifts we can give, positively affecting our children for the rest of their lives, and long after we are gone, is something that we should have in place 270 days before we even meet them for the first time?

Yes, extensive research now confirms that the first 1,000 days of life, i.e. from the start of pregnancy to around the age of 2 years (+-270 days in the womb and the next 730 days after birth), is both a critically vulnerable period as well as a major opportunity for our children. Just stop for a moment and imagine, during these 1,000 days, we evolve miraculously from a single cell, invisible to the human eye and weighing nothing, to a now, very loud, very mobile, inquisitive little toddler comprising of trillions of cells and weighing around 12kg’s! So many complicated events are taking place during this time – think of the developing brain and spinal cord with its billions of cells and networks, think of the little heart with its 4 chambers and valves needing to form perfectly and more than 50,000km of blood vessels leading to and from it, the list is endless, and the steps infinite, there is such potential for things to go wrong isn’t there? Just as important though, researchers refer to the first 1,000 days as ‘a window of opportunity’ not just to get things right, but to get things really right for the child to reach their potential, academically and psychologically. Unfortunately, science also confirms that amongst other important requirements, if the nutritional needs of the infant are not met or corrected (if necessary) during this window, the consequences may be lifelong, irreparable, compromised brain function leading to suboptimal crucial functions like learning, memory, attention and even IQ.

Baby toes

Nutritional needs during the first 1,000 days for neurological health

For our children to develop healthy brain and nervous systems, they need to grow up in a supportive environment with loving parents and have a healthy diet. Extensive research confirms that factors such as poverty, emotional deprivation, stress, infections, and malnutrition all lead to suboptimal brain development. In this article, however, we will focus specifically on the nutritional needs our children have and how to ensure they are in place.

The first 1,000 days can be divided into three stages: pregnancy, infancy, and early childhood. In all three stages the infant grows rapidly and becomes more and more complex , with no one stage being more important than another, yet for all to take place optimally, there is no room for any form of malnutrition. It’s important to realise that malnutrition includes both ‘undernutrition’ i.e. not enough micro and macronutrients as well as ‘overnutrition,’ simply getting too many, something which even those living in poverty are at risk of. We call this ‘high calorie malnutrition’ where staple diets consist of heavily or affordable, highly refined starchy foods with poor nutrient levels – basically the tummy feels full but the body is still craving vital nutrients!

Pregnancy (the first 270 days of life)

It goes without saying that mom’s health directly impacts on the unborn child. When we use the term ‘health’ we mean health in the true sense of the word, i.e. her physical, mental and social well-being, not just the absence of disease, as most presume it to be. Included in this, importantly, is her nutritional state so that she can provide all the vital nutrients for her rapidly developing baby which, by the 4th week of pregnancy, already has 10,000 brain cells and astonishingly, by the 24th week of pregnancy, has 10 billion brain cells! Expecting mothers should have a balanced and diverse diet consisting of nutrient dense foods – the foods that are unrefined, unprocessed and packed with nutrients. An ideal diet during pregnancy should include good quality proteins such as fish, dairy products, poultry, legumes, beans, pulses as well 5-6 servings of vegetables and fruits daily, nuts and seeds, and unrefined grains. These provide the critical nutrients for optimal brain development and include iron, protein, copper, folate, zinc, iodine and essential fatty acids. These specifically help in forming the millions of nerve circuits and highly specialised sections of the brain and central nervous system.

Infancy (from birth to 1 year)

At birth, babies now have 200 billion brain cells and the brain continues to grow by 1.7 grams every single day, demanding so much nutrition that up to 60% of the infants energy intake is consumed by this hungry brain alone! By the time they have their first birthday, most infants are now highly mobile and exploring their surroundings with some taking their first few steps. They also don’t only recognise their own name but up to 70 other words too, and are starting to say a few as well. Essentially, for the first 6 months or so, breastmilk is all the superfood they need to thrive. Breastfed infants not only show to be physically healthier, but they even score better on intelligence tests later in childhood, and topping up with extra breastmilk until 12 months has been shown to even increase IQ by 3 points. Since healthy brain development also depends on how the brain is stimulated in this time and the experiences the infant has, a loving and nurturing environment as well as bonding with mom is essential, something the breastfeeding experience helps to establish.

Don’t forget that to produce healthy breastmilk, moms have to still maintain their healthy diet like they did when they were pregnant, and ensure they don’t become deficient in any nutrients themselves. Breastfeeding on top of 9 months of pregnancy can place moms at risk of deficiencies which are often not checked for after baby is born – this is especially important for moms who fall pregnant again soon after giving birth.

Early childhood (from 1 – 2 years)

By age two, toddlers start to imitate us and others, and have around 300 words in their vocabulary – they are now becoming little people, wanting to do things themselves and only their way, no wonder they call it the ‘terrible twos’! Their brains start to resemble ours and are around 70% the size of the adult brain during this time.

Believe it or not, by age two, toddlers have around 100 trillion nerve connections called synapses. Interestingly, this is the highest number they will have in their entire lives, which allows the brain to be influenced and moulded by the stimulation and experiences our toddlers are exposed to, something researchers call ‘neuroplasticity.’ These young brains crave healthy stimulation like our voices, cuddles, music, touch, visual stimulation and the essential nutrients needed to build these connections, specifically protein, iron, zinc, and iodine. Since most toddlers are weaned by now, we can’t rely on breast milk top ups to fill in any dietary deficiencies which may creep in with these fussy eaters. This is a time where we have to be very careful that our toddlers are meeting their nutritional requirements, and supplementation of micronutrients specifically should be introduced.

Toddlers need to be exposed to a wide variety of healthy proteins, vegetables, fruits, unrefined grains, and unsweetened dairy products with limited salt, sugar, and saturated fats. Research shows that the more opportunities we give them to try new things, the more likely they are to eat them. Very importantly, to establish healthy eating habits, we need to introduce a routine with meal and snack times, switch off the TV and minimise other distractions and create a positive, happy atmosphere where we give them our full attention. Since these little people imitate what we do, it’s important that they see us eating and tasting the same new foods. This encourages them to do the same. We should avoid forcing them to eat more, using foods as rewards, or any behaviour which turns meal times into stressful situations for them.

Pregnant lady with smoothie

Special emphasis on iron

As mentioned, there are a variety of essential nutrients needed during the first 1,000 days to ensure healthy growth and development of our children. Iron, however, is critically important in pregnancy, infancy and early childhood. More so, if iron deficiency is present and not corrected by age 2, the harmful effects of what is known as ‘brain iron deficiency’ are permanent and cannot be reversed with supplementation later on in life.

Iron deficiency is one of the most common deficiencies in the world and maternal iron deficiency, i.e. lack of iron while pregnant, occurs in as many as 56% of women in low to middle income countries. Even in countries such as the UK up to 50% of women in their child bearing years have low iron stores.

Who is most at risk?

Mothers who have had multiple pregnancies, especially when close together, often enter the next pregnancy with low iron stores depleted by the previous pregnancy and months of breastfeeding, which places them and their unborn child at risk. Teenagers who fall pregnant and their babies are also at risk – why? Because mom is still growing and developing her own body and needs iron to do that, leaving little iron to support a healthy pregnancy. These, together with other negative influences such as malnutrition, or the inability to absorb iron from the gut, heavy periods or chronic infections further add to the problem and increase the risk of mothers entering a pregnancy with low iron reserves.

How does one screen for this?

Often expecting mothers have a simple haemoglobin test or at best, a full blood count blood test at the beginning of pregnancy which simply measures haemoglobin levels, and not the essential iron stores or reserves which can be low despite having a normal haemoglobin level. It’s these iron stores that are often depleted later in pregnancy, which then lead to low haemoglobin. Unfortunately most moms don’t have their iron status rechecked at birth and may start motherhood and breastfeeding with low iron levels without knowing so.

Consequences of low iron stores for moms?

Maternal iron deficiency has been extensively researched and research has confirmed that mothers with a deficiency in iron are at risk of:

  • Excessive fatigue and low productivity (during and after pregnancy).
  • Weakened immune systems and increased risk of infections.
  • Heart and circulatory problems (palpitations, fainting, difficulty breathing).
  • Complications of pregnancy (infections, high blood pressure, excessive bleeding).
  • Emotional problems and difficulty bonding or coping with their new-borns (baby blues).
What are the consequences of iron deficiency for the new-born?

Infants born to anaemic mothers:

  • May have low birth weight and stunting (restricted growth in the womb).
  • May be born ‘preterm’ (born too early).
  • May have lower APGAR scores at birth.
  • May be stillborn in severe cases.
  • Are at high risk of brain iron deficiency.

Happy smiling child

Brain iron deficiency and its implications

In the first 1,000 days of life, the demand for iron follows what is known as a ‘blood over brain’ principal. This means iron is used first to make red blood cells and then, what is left over, can be allocated to the brain for its growth. The problem is that iron is absolutely critical for early brain and nervous system development, and if there isn’t enough to go around, ‘brain iron deficiency’ occurs. What makes matters worse is that the brain can only absorb iron until around the age of two, i.e. for the first 1,000 days of life – yes, you heard correctly, after age two, even if one corrects anaemia with the best supplementation, it can’t be absorbed by the brain, leading to permanent residual brain iron deficiency.

Research confirms that brain iron deficiency:
  • Negatively affects the temperament and behaviour of the child.
  • Negatively affects memory, concentration, and IQ.
  • May lead to mental and psychomotor deficits and abnormal reflexes.
  • Is associated with increased risk of mental illness.
  • Is associated with sleep problems, allergies and wheezing.

The evidence makes it very clear that we need to do more to prevent the irreparable harm caused by brain iron deficiency and the permanent, negative consequences it may have for our children. We can start to achieve this by:

  • Educating mothers on this condition and how to prevent it through proper screening, healthy diet, and supplementation.
  • Comprehensively test mother’s iron status at the start, during and end of pregnancy and test cord blood ferritin levels at birth to screen infants.
  • Starting supplementation earlier, especially in high risk mothers and infants born to anaemic mothers.
  • Promoting breast feeding of all infants until at least 6 months of age or longer if possible.
  • Educating mothers on healthy nutrition during pregnancy and breastfeeding and how to ensure their babies meet their nutritional needs in early childhood.
  • Lobbying government to provide for more comprehensive screening, education and supplementation for expecting moms and the provision of supplementation and fortified foods for their infants at least until age 2.

Mother with daughter

How can Bio-Strath help?

Bio-Strath contains 61 of the 100 vital nutrients our bodies need daily, in a unique format that is highly absorbable by the human body. Included in these are 11 vitamins, 19 minerals and trace elements, 20 amino acids and unique to Bio-Strath, 11 building substances. Building substances are special because they are the nutrients our body needs first to make new cells! Since Bio-Strath is a food, its safe to use in pregnancy, breastfeeding and to give our babies.

Bio-Strath is an important consideration for both pregnant and breastfeeding moms and their babies especially during the first 1,000 days. Why? Because Bio-Strath is clinically proven to support and maintain haemoglobin levels throughout pregnancy, preventing these levels from typically dropping as pregnancy advances, and it’s proven to enhance the absorption of iron by 5 times! Iron is not the easiest nutrient to absorb, and supplements, although necessary to correct deficiency, often cause constipation. When taken with iron supplements, Bio-Strath allows 5 times more to be absorbed in the intestine. In fact, it helps the absorption of other essential nutrients too such as magnesium, zinc and vitamin B1. After all, ‘It’s easier to build strong children than repair broken men.’

This article originally appeared on Living Naturally and can be found here.

For more information, please visit the Bio-Strath website here.

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