Looking Back on Our First 1,000 Days

August 3rd, 2016 | Viewpoint

Kristina Granger and Jackson. Photo credit: Second Ave Photography, proud supporter of breastfeeding.
Kristina Granger and Jackson.
Photo credit: Second Ave Photography, proud supporter of breastfeeding.

Two years ago, I had the pleasure to share my experience as a new breastfeeding mom from the perspective of a social and behavior change specialist for USAID’s Strengthening Partnerships, Results, and Innovation in Nutrition Globally (SPRING) Project, where we work to improve infant and young child feeding practices around the world. Although my experience as a mother in the United States is vastly different than the majority of mothers that our programs work with, motherhood provides me a better lens through which to empathize and understand their daily fears, struggles, joys, and experiences.

One of the biggest struggles I encountered has been breastfeeding as a working mom. Although this challenge is very real for those of us who work away from home in the U.S., it presents unique challenges for mothers in developing countries who have to return to the fields or factories to work just a few weeks or even sooner after giving birth. I’ve been lucky to be part of an organization that provides a private space, allows time to pump, and has refrigerators for storing milk, but even with these allowances it has been a struggle to pump between workload, meetings, and visiting our country offices. I have overcome many of these challenges, but my experiences have made me  appreciate how difficult it can be for the moms I work with to exclusively breastfeed—even when they know that it can help their child get the nutrients he or she needs to stay healthy.

The fact that I have access to an electric pump (and the countless batteries or regular electricity to operate it!) is well beyond the means of many mothers. Moms in rural areas may not be able to stay with or get home to their baby throughout the day, to bring their baby with them to work, or to express milk manually and store it in a clean, dry area. I’ve had to hand express milk when my pump failed me and experienced how difficult that is—and yet it is often the only option for women who work and want to continue to breastfeed. In urban areas in low-income countries, similar problems exist, with the additional challenge of work place norms that don’t often support women who are nursing, but for many moms around the world, the options I’ve had just aren’t available.

Thankfully, things are starting to change in some countries. For example, Vietnam recently passed laws protecting six months of maternity leave for women to help enable them to exclusively breastfeed. This is a huge gain for working women, but it still leaves the subsistence farming mother in a remote area, who doesn’t depend on an employer, with little assistance to breastfeed her children through the first 1,000 days.

Another difficulty I encountered, which my peers in the U.S. understand as easily as women across the globe, is the ability to feed my child nutritious and fresh complementary foods instead of resorting to quick and cheap processed meals or snacks. I’ve seen a Facebook post pop up time and again on the 25 must-have words a 2-year-old should know. Front and center in the list: juice and cookie. Every time I see this, it stresses how ingrained junk food is in our daily lives. And this isn’t just a problem in high-income countries.

The data show a growing global issue of the double burden of malnutrition (where overweight and underweight both exist in high numbers in the same country). In the countries where SPRING works, we are seeing more and more that cheap snack foods, fried foods, and sweet biscuits are being used as complementary foods for young children under two because they are easy to buy in tea stalls or markets, are cheap, and calm the young child quickly (albeit often temporarily). When moms understand the importance of giving their children nutrient-dense foods, it can help improve young child nutrition, but knowledge alone isn’t enough. It’s also important that they have access and resources to get those foods.

I can’t claim to be a perfect mom who has never bought pre-packaged food for my son. But as a public health professional with the knowledge and access to high quality food, who still finds it difficult to give my son only high quality food, it’s clear how complex a process it can be to change behaviors—in low-income and affluent communities.

As a single, working, breastfeeding mom, I could never have pulled it off alone to ensure that Jackson and I regularly had nutritious meals and snacks. My own mother’s help was critical to this effort. Especially as Jackson started eating complementary foods, she would make us both healthy meals on days when I was working late or just couldn’t keep up with the house, work, and caring for myself and my son. Having her there to help reinforced to me how important it is for women to have a support system to enable them to successfully breastfeed and care for a young child.

Many moms that SPRING works with count on the support and guidance of their own mothers (or more typically, their mothers-in-law) with their young children. Fathers also play an important support role in the family unit. As we work to help more mothers incorporate healthy young child feeding behaviors, we see that these key influencers also play an important role in our work. It’s critical to reach the entire family to promote recommended healthy young child feeding behaviors like immediate breastfeeding after birth and adequate complementary feeding of children 6-24 months of age, so that they can support mothers.

As we recently celebrated my son’s second birthday and crossed the threshold of the first 1,000 days, I spent a lot of time reflecting on this critical window of opportunity for providing him with the best possible start in life. Watching how much my son has grown physically, emotionally, and mentally, it’s easy to see how important his diet has been to making sure he is as healthy as possible.

Facing my own challenges with breastfeeding, pumping, and complementary feeding despite a supportive work environment, help from my family, and relatively easy access to healthy food has given me even more respect for the mothers and communities SPRING works with who overcome even greater barriers to making breastfeeding and healthy eating a reality in their lives. Their determination to improve their children’s nutrition inspires me more every day and only increases my conviction in the importance of continuing to work for better nutrition through promoting behaviors like exclusive and continued breastfeeding and quality complementary feeding to ensure children receive adequate nutrients from day 1—and long past day 1,000.

Written by Kristina Granger

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