SEATTLE — Every mother dreams of a bright future for her child. One of the most fundamental keys to success in life is nutrition. The first 1,000 days of life form the most critical period of development. Children deprived of proper nutrition during the first 1,000 days often suffer the consequences for the rest of their lives.

Five weeks after conception marks the beginning of the embryonic period. During this period, essential organs including the brain and spinal cord begin to form. By week six, the neural tube, which gives rise to the central nervous system, has closed. Nutritional deficiencies in the mother’s diet during this crucial period can lead to lasting consequences for the child. Neural tube defects can lead to serious birth defects such as spina bifida or anencephaly, the absence of a major portion of the brain, skull, or scalp.

The good news is, most of these defects are preventable with the right interventions during the first 1,000 days. Maternal supplementation with only 400 micrograms of folic acid has been shown to be effective in reducing the risk of neural tube defects. To avoid stunting in children, though, mothers need much more than a single vitamin supplement.

Characterized by lower than average height for age, the consequence of chronic malnutrition is stunting. Associated with poor performance in school, stunting afflicts more than one in four children. Although stunting may not be evident in the first 1,000 days of a child’s life, there is no question it is a consequence of malnutrition during that critical period.

Between 1990 and 2011, the prevalence of stunting was reduced by 36 percent, but there is still much work to do. The World Health Assembly made it a goal to reduce stunting in children under 5 years of age by another 40 percent by 2025. To do so, simple but cost-effective interventions need more investment.

These interventions need to begin while the child is still in the womb, where the importance of maternal nutrition is paramount. Protein and lipid supplements for pregnant women have been effective in improving child growth. After delivery, continued nutritional support for mother and child are critical, as breastfeeding has demonstrated myriad benefits for the child. Though the benefits of improved nutrition are not always immediately appreciable, studies suggest it is highly cost-effective. Conservative models suggest a 30-fold return on investment in very poor countries.

If global goals for the prosperity of all are to be met, this health problem must be addressed first. Though no formal learning occurs in the first 1,000 days of a child’s life, there is no other period that has as much influence on their future success.

– Rebecca Yu

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