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Menu | Glossary | References Role of Nutrition in the First 1,000 Days Foundational eLearning Module START COURSE CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES.  Menu | Glossary | References Role of Nutrition in the First 1,000 Days Disclaimer Information shared in ANY eLearning module is for your background knowledge only and is not to be shared, discussed, or referenced with anyone outside of Wyeth Infant Nutrition. Any engagement with contacts must take place in accordance with Wyeth Infant Nutrition policies and guidelines. PREVIOUS 2 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days Important Notice The World Health Organization (WHO*) has recommended that pregnant women and new mothers be informed on the benefits and superiority of breast-feeding – in particular, the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial formula-feeding or other foods and drinks should be discouraged since it will have a negative effect on breast-feeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breast-feed. Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than 400g per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast-milk is not only the best, but also the most economical food for babies. If a decision to use an infant formula is taken, it is important to give instructions on correct preparation methods, emphasizing that unboiled water, unsterilized bottles, or incorrect dilution can all lead to illness. The World Health Organization recommends exclusive breastfeeding during the first 6 months of life and continued breastfeeding for as long as possible. As babies’ growth and development needs vary, health professionals should advise the mother when her baby should start receiving complementary food. *See: International Code of Marketing of Breast Milk Substitutes, adopted by the World Health Assembly in Resolution WHA 34.22, May 1981. I ACCEPT PREVIOUS 3 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days Welcome to the Role of Nutrition in the First 1,000 Days module. The goal of this module is for learners to gain an overview of the critical role that nutrition plays during the first 1,000 days of life, the time from conception through 2 years of age. This module is divided into 4 chapters: 1. Healthy Growth in Early Life 2. Prenatal Nutritional Factors 3. Nutritional Factors Related to Infant Feeding 4. Nutritional Factors Related to Complementary Feeding Several Progress Checks are included throughout the module to ensure key concepts are learned. This module should take you approximately 45 minutes to complete. PREVIOUS 4 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days Learning Objectives After completing this module, you will be able to: Define healthy growth trajectories in the first 1,000 days Describe the prevalence of sub-optimal growth trajectories in infants and children worldwide Discuss the importance of prenatal nutrition and infant/child feeding practices to support appropriate early growth and health outcomes PREVIOUS 5 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days 1 Healthy Growth in Early Life PREVIOUS 6 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days 1 Healthy Growth in Early Life 2 Prenatal Nutritional Factors 3 Nutritional Factors Related to Infant Feeding 4 Nutritional Factors Related to Complementary Feeding The first 1,000 days is a sensitive window of growth and development Mounting evidence indicates that the first 1,000 days following conception through a child’s 2nd birthday is a critical window of time during which many crucial growth and developmental processes occur.1 Proper growth and development during this critical period sets the foundation for a child’s physical, emotional, and intellectual wellbeing throughout life.1 2 years Conception PREVIOUS 7 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days 1 Healthy Growth in Early Life 2 Prenatal Nutritional Factors 3 Nutritional Factors Related to Infant Feeding 4 Nutritional Factors Related to Complementary Feeding Global growth standards Length-for-age GIRLS3 Child growth is the most widely used indicator of nutritional status in a community.2 Birth to 2 years (z-scores) The World Health Organization (WHO) conducted the Multicentre Growth Reference Study (MGRS) to develop the WHO Growth Standards that could be used to assess the growth and development of children worldwide.3 These standards illustrate how children should grow on average in all countries, when properly fed and cared for.3 Growth curves are available for: Length/Height-for-age (HAZ) Weight-for-length (WHZ) Weight-for-length BOYS3 Birth to 2 years (z-scores) Weight-for-age (WAZ) BMI-for-age (BMI = body mass index) The example growth curves on the right are derived from the WHO Growth Standards. The top chart shows healthy length-for-age for girls from birth to 2 years of age, and the bottom chart shows healthy weight-for-length for boys in the same time frame. CLICK EACH CHART TO ENLARGE THE IMAGE. PREVIOUS 8 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days 1 Healthy Growth in Early Life 2 Prenatal Nutritional Factors 3 Nutritional Factors Related to Infant Feeding 4 Nutritional Factors Related to Complementary Feeding Global growth standards Weight-for-length GIRLS3 × Birth to 2 years (z-scores) Length-for-age GIRLS3 Child growth is the most widely used indicator of nutritional status in a community.2 Birth to 2 years (z-scores) The World Health Organization (WHO) conducted the Multicentre Growth Reference Study (MGRS) to develop the WHO Growth Standards that could be used to assess the growth and development of children worldwide.3 These standards illustrate how children should grow on average in all countries, when properly fed and cared for.3 Growth curves are available for: Length/Height-for-age (HAZ) Weight-for-length (WHZ) Weight-for-length BOYS3 Birth to 2 years (z-scores) Weight-for-age (WAZ) BMI-for-age (BMI = body mass index) The example growth curves on the right are derived from the WHO Growth Standards. The top chart shows healthy length-for age for girls from birth to 2 years of age, and the bottom chart shows healthy weight-for-length for boys in the same time frame. CLICK EACH CHART TO ENLARGE THE IMAGE. PREVIOUS 9 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days 1 Healthy Growth in Early Life 2 Prenatal Nutritional Factors 3 Nutritional Factors Related to Infant Feeding 4 Nutritional Factors Related to Complementary Feeding Global growth standards Weight-for-length BOYS3 × Birth to 2 years (z-scores) Length-for-age GIRLS3 Child growth is the most widely used indicator of nutritional status in a community.2 Birth to 2 years (z-scores) The World Health Organization (WHO) conducted the Multicentre Growth Reference Study (MGRS) to develop the WHO Growth Standards that could be used to assess the growth and development of children worldwide.3 These standards illustrate how children should grow on average in all countries, when properly fed and cared for.3 Growth curves are available for: Length/Height-for-age (HAZ) Weight-for-length (WHZ) Weight-for-length BOYS3 Birth to 2 years (z-scores) Weight-for-age (WAZ) BMI-for-age (BMI = body mass index) The example growth curves on the right are derived from the WHO Growth Standards. The top chart shows healthy length-for age for girls from birth to 2 years of age, and the bottom chart shows healthy weight-for-length for boys in the same time frame. CLICK EACH CHART TO ENLARGE THE IMAGE. PREVIOUS 10 CONFIDENTIAL—EDUCATIONAL AND TRAINING MATERIALS. DO NOT DETAIL OR DISTRIBUTE TO ANY THIRD PARTIES. NEXT NEXT  Menu | Glossary | References Role of Nutrition in the First 1,000 Days 1 Healthy Growth in Early Life 2 Prenatal Nutritional Factors 3 Nutritional Factors Related to Infant Feeding 4 Nutritional Factors Related to Complementary Feeding What are z-scores? Throughout the module, we will continue to review data on nutrition and growth. Most data used to describe growth patterns in children are presented in z-scores, which are standard deviation scores that show how a child’s growth compares with growth in a reference population.2 Reference standard z-scores have been developed by the World Health Organization.2 Growth outcomes, such as underweight, overweight, and stunting, are defined based on the number of standard deviations from the mean of the population.2 The example below shows the definitions of underweight and obesity, relative to the reference weight-for-age z-score. Weight-for-age GIRLS3 Birth to 2 years (z-scores) Obesity is when weight-for-age is >3 standard deviations Underweight is when weight-for-age is