Securing a child’s future in the first 1,000 days of his/her life – from conception itself

Located near the infamous Arthur Road Jail, the Foundation for Mother and Child Health’s (FMCH) main programme is quite a foresight-ful one. The organisation fights malnutrition by making efforts that start right at the beginning: from pregnancy! As they believe that a child’s future can be secured in the first 1,000 days from conception itself.  “If a child has good nutrition from conception until his/her second birthday, s/he will grow healthily and his/her brain will develop to full potential. This is important to give children a good future. Without proper nutrition during this time, the brain will not develop properly, and the child may be stunted (short) with chronic malnutrition,” says Rosie Penrhyn Jones, co-chair of the UK arm of the organisation.

In this endeavor, they work with women from Mumbai’s slums; and focus on child development through health and nutrition. This is done by conducting talks to organizing typhoid vaccination camps, to keeping a check on anemia levels and weight through checkups, holding cooking classes and even doing home visits. Infact one of their programmes is called, “The First 1,000 Days programme.” It includes an innovative Pregnancy Club, early growth monitoring, education on early and exclusive breast feeding, weaning advice, as well as the importance of eating healthy.

“Malnutrition is a preventable problem, and there is a solution,” says Rosie.

The women they work with hail from underprivileged communities; women who carry out daily chores despite being pregnant. They thus have little time for themselves and their babies. These women also hail from families where the head of the family earns about Rs. 200 a day at best. So, since FMCH cannot make up for low income levels and change their way of life, they work on what they can change.

Like overcoming their lack of education, which is one of the leading causes of malnutrition amongst toddlers today. This is done by educating women when they are pregnant and counselling them on the importance of breastfeeding.

Of course, it’s quite a challenge to do so. Primarily because it takes time to gain mothers’ trust. “But when they begin to see the benefits, they come back and invite their neighbors to the workshops and sessions too,” says Rosie.

During my visit, the doctor at the clinic showed me growth charts that they maintain for each of the babies under their supervision. There was a remarkable difference in terms of growth between a baby who became part of the programme in the early weeks after birth to another who arrived when he was older. There was also a 2 year old child, who weighed just 8 kilos! 8 kilos is what a 9 month old baby should weigh!

So, bringing one’s children younger rather than older to the clinic is clearly one of the topics covered. Other topics include the use of formula milk. This can be dangerous because some women over-dilute the milk powder; that too with water, which may not be clean, thus causing diarrhea in babies. Breastfeeding on the other hand guarantees immunity and protects the baby.

Traditionally, women do not take their babies out of their home until they are 40 days old. However, FMCH encourages them to do so for the FMCH clinic check up only. In some cases, the FMCH staff also visits the mothers’ homes; to advise them on measures like gas, stove etc. that will ensure the safety of children inside the house.

Parents are also encouraged to talk to their children so as to stimulate their brain’s development.

Another important topic covered is child spacing. FMCH advises mothers to keep a gap of 3 years between pregnancies so that each child may get enough attention from the parents.

I also attended a cooking demo. FMCH’s cooking demos serve a dual objective. One is to show mothers how to cook a balanced healthy meal. The other is to demonstrate that it is possible to cook and eat healthy even with a very limited budget. The cost of a balanced meal as per FMCH standards works out to be Rs. 50 or less for a family of 4.

In a very interesting move, mothers with well-nourished children are invited to conduct FMCH’s cooking demonstrations. This is “Positive Deviance”, a development tool which identifies (using the nutrition example) successful examples that can be followed and emulated by the community. In this case, children who are growing well are identified, and their mothers share their eating patterns (and recipes) with all in the hope that those practices will be adopted by the community.

FMCH meets the mothers with their babies as often as twice a week. Fathers are encouraged to attend the workshops and sessions too. Many times, mother-in-laws attend out of pure curiosity! But this curiosity is encouraged because if women have the support of their mother-in-law, things are better for them at home, and in the community.

In a city like Mumbai, where roughly 9 million people live in slums, the importance of FMCH’s work cannot be stressed on enough.

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