First 1000 Days of Life Are the Key

WASTED STUNTED (Thin) (Short) Normal height

60% 2005-05 2015-16 50% 48%

40% 38%

30% 20% 21% 20%

10%

NORMAL 0% Stunting Wasting UNDERNUTRITION TREND BY AGE 6 months to 24 mo crucial: adult height is set at 2 years of age 60 Stunted

50 Stunted

% children % children 20

Wasted 10

Stunted 0 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 Age in months

Height at 2 years determines adult height, NFHS 4: 2015-16 productivity and income First 1000 days of life are the key

• Period of rapid brain growth and maturation:

80% by 2 years 4 1000 days are the key • Undernutrition occurs in the first and the second year • First 1000 days determine the sensory, language and cognitive development • Linear growth failure in this period is associated with adult short stature • Consequence: Less strong, less smart child – Compromised cognition, learning, IQ – Low productivity, income – Lower offspring birthweight (females)

5 Three reasons why kuposhan occurs

• Low weight at birth: 25% • Serious illnesses: Diarrhea and pneumonia – 25% • Inadequate food intake – 50%

6 Food

• Breast feeding – Initiate within one hour – Nothing else for first 6 months – Continue upto 2 years or more

• Semi-solid food from 6 months onward (Complementary feeding / Poorak ahar)

7 8 India: adequacy of complementary feeding for children 6-24 months of age, 2006-2016

%70 receiving adequate complementary Adequate diet 2006 Adequate diet 2016 feeding 60 90% of our young children are nutrition hungry 50

Adequate diet = child 6-24 fed either breastmilk/source of dairy; and age-appropriate number of food groups and age-appropriate number of meals per day NFHS-3 indicator calculation by IFPRI; NFHS-4 indicator as reported in fact sheets. Immediate determinants (2006-2016): Limited progress on IYCF and child health

Source: NFHS-3; NFHS-4 Complementary feeding

11 What to feed

1. CEREAL Wheat or rice (Carb)

2. DAL Thick mashed (Protein) 3. VEG / fruit Seasonal veg / Pulp fruit (banana, papaya) mashed 4. OIL Oil, butter, ghee 5. MILK Milk and products Jaggery, sugar, As accepted Egg

Take home ration

12 What to feed

1. CEREAL Wheat or rice (Carb) Khichri, thick dal, dalia, soft roti, sattu, poa, soft idli, 2. DAL Thick mashed suji kheer, rice kheer (Protein) 3. VEG / fruit Seasonal veg / Added vegetable / fruit Pulp fruit (banana, papaya) mashed 4. OIL Oil, butter, ghee Add extra on top 5. MILK Milk and products Take milk without dilution by cup/glass Jaggery, sugar, Egg Take home ration

13 1. Consistency • Semi solid, thick liquid 2. How much • 6 m – 1 year : 1/2 to 1 katori

• After 1 year : 1 to 11/2 katori 3. How often • 6 m – 1 year : 3 times • After 1 year : 5 times 4. How • Pyar se, aaram se

14 Energy density 1. Continue breastfeeding

3. Feed with spoon

2. Wash hands 16

18 19 20 ✓2 sessions of Poorak ahaar demonstration in groups in

each village.