Audio Transcript Auto-generated
- 00:00 - 00:00
Hello.
- 00:01 - 00:03
Hi, there I am a joke.
- 00:03 - 00:04
He had a William, a medical doctor,
- 00:04 - 00:10
a senior resident of the department of community at the University of Lagos,
- 00:10 - 00:11
Nigeria,
- 00:11 - 00:14
And I want to take you through a shock Master Master
- 00:14 - 00:17
class on the nutrition in the 1st 1000 days of life,
- 00:18 - 00:19
Um, you should know that
- 00:20 - 00:27
the 1000 and the 1st 1000 days of life very, very sensitive they are the most, um,
- 00:27 - 00:32
they're the period in which maximal brain developmental cause it
- 00:32 - 00:34
is a period between when a child is first concept.
- 00:34 - 00:36
So the day one of a child in the mother's womb.
- 00:36 - 00:40
So the child is two years when you count that roughly daily, that's about
- 00:41 - 00:42
1000 days.
- 00:42 - 00:46
And the experts have done a lot of research to state that this is a period where
- 00:47 - 00:51
whatever that child um is exposed to nutritionally in
- 00:51 - 00:57
and other aspects of Israel environment determines whether a child
- 00:57 - 01:00
goes on to have what we call metabolic programming as
- 01:00 - 01:02
in terms of the metabolic programming of the child.
- 01:02 - 01:07
And if the child goes on to have n citizen future like a potential diabetes,
- 01:08 - 01:11
it's also the period that can that can
- 01:11 - 01:13
affect the intelligence of a child,
- 01:13 - 01:17
the immunity of a child because we are investigating the gut brain axis and the best.
- 01:17 - 01:21
Um, that being said, I'm going to move right in,
- 01:21 - 01:22
and we're going to be discussing
- 01:22 - 01:25
the first intergenerational cycle of malnutrition.
- 01:26 - 01:30
This international cycle of malnutrition tries to describe
- 01:31 - 01:32
I'll.
- 01:32 - 01:36
A person is affected by malnutrition at every stage of their lives.
- 01:36 - 01:40
Now we know that in a lot of developed world,
- 01:40 - 01:43
the problem must is more in the line of over nutrition.
- 01:44 - 01:45
But in the developing world,
- 01:45 - 01:50
it is becoming not only or the nutrition but the nutrition and over nutrition.
- 01:50 - 01:52
Before, it used to be a problem of just under nutrition,
- 01:52 - 01:55
and that's under nutrition and over nutritional.
- 01:55 - 01:57
What are being referred to in this
- 01:57 - 02:00
lecture by malnutrition now factors in pregnancy.
- 02:01 - 02:02
This is, um,
- 02:02 - 02:06
shows from a child from when the child is a concept us
- 02:06 - 02:09
to a new unit to being a total of preschool age,
- 02:09 - 02:11
school age puberty and adults.
- 02:11 - 02:15
It just shows that, um, whatever you feed a child, especially women.
- 02:15 - 02:16
I mean, what men and women, anyways?
- 02:16 - 02:17
Well,
- 02:17 - 02:19
when you feed a child and the child
- 02:19 - 02:23
has malnutrition and the child cannot develop voluntary LD
- 02:23 - 02:26
adult or is not achieving the maximum potential
- 02:26 - 02:29
that his brain should be able to accommodate.
- 02:29 - 02:35
That child goes on to have a child that may be stunted, overweight or as some issues.
- 02:35 - 02:41
So this just shows that you you have to give adequate
- 02:41 - 02:44
attention to a child's nutrition and environment in the 1st 1000
- 02:44 - 02:47
days of life so that you do not trigger the cycle
- 02:47 - 02:51
that leads to a population of people that have malnutrition.
- 02:52 - 02:52
Mm
- 02:52 - 02:55
um, that being said, we are going to
- 02:56 - 03:01
Yes. So I was reviewing factors here during the conceptual period.
- 03:01 - 03:02
Of course,
- 03:02 - 03:04
maternal diet is important When a woman eats foods that
- 03:04 - 03:08
are deficient in micronutrients like fully cast seed and,
- 03:08 - 03:10
um, vitamin D i O.
- 03:10 - 03:12
And the rest. The woman
- 03:13 - 03:16
does not have enough micronutrients to give for the baby's brain functioning.
- 03:16 - 03:20
When a woman has an infection from the torches syndrome that's toxoplasmosis,
- 03:20 - 03:26
rubella, cytomegalovirus and the rest the the child's brain will not develop well.
- 03:26 - 03:30
Intra uterine infections to an ambient air pollutions are not left out.
- 03:30 - 03:35
We also know that when a child is a neonatal period,
- 03:35 - 03:38
things like low birth weight, small for gestational age,
- 03:38 - 03:41
all triggered by Not all of them are triggered by nutrition,
- 03:41 - 03:43
but which nutrition triggers
- 03:43 - 03:46
prematurity, iPods and cell anaemia. Hypothyroidism?
- 03:46 - 03:48
A small It's a conference,
- 03:48 - 03:50
this all impact the Natal period and the
- 03:50 - 03:53
brain development of a child during this period.
- 03:53 - 03:55
That being noted,
- 03:55 - 03:58
we also know that in the infantile period that is a
- 03:58 - 04:02
period between a child being a new net and a child
- 04:02 - 04:04
being one year old. We know that
- 04:04 - 04:09
if you introduce non breast milk foods at less than six months of age,
- 04:09 - 04:11
this kind because this can impact the nutrition of
- 04:11 - 04:14
a child and the brain development of a child.
- 04:14 - 04:15
That being said,
- 04:15 - 04:17
we would like to state at this point that
- 04:17 - 04:20
the World Health Organisation states categorically that the breast milk
- 04:20 - 04:23
exclusive breast milk is the gold standard for feeding
- 04:23 - 04:25
a child in the first six months of life,
- 04:25 - 04:29
and after six months of life, a child should be started on complementary food.
- 04:29 - 04:33
Now we know that for many reasons a woman is not able to breastfeed a child,
- 04:33 - 04:39
and in that case, other breast milk substitutes have been advocated for
- 04:39 - 04:42
and in the period, so many people introduce adults diet
- 04:43 - 04:45
at less than six months of age.
- 04:45 - 04:47
This is very detrimental to a child's brain development,
- 04:47 - 04:51
because a child is a particular level of I on a particular level of zinc,
- 04:51 - 04:54
and all these things are found in milk,
- 04:54 - 04:57
specifically breast milk and other milk substitute.
- 04:57 - 04:58
Now they are poor,
- 04:58 - 05:01
complimentary feeding practises like I've mentioned
- 05:01 - 05:04
pour water hygiene and sanitation issues,
- 05:04 - 05:07
recurrent infections, exposure to mycotoxins, maternal depression.
- 05:07 - 05:10
These are other environmental issues which, along with nutrition,
- 05:10 - 05:14
can impact a child's development during this period.
- 05:14 - 05:15
Um,
- 05:15 - 05:21
that be in said, we're going to talk about what we talked about the cycle.
- 05:21 - 05:22
Yes,
- 05:22 - 05:27
and we're going to talk about what complementary feeding does during this period.
- 05:27 - 05:28
Now, if we are back here,
- 05:28 - 05:33
we can see that complimentary feeding is defeating that we give a child.
- 05:33 - 05:37
After six months or so. Let's assume that you breastfeed a child at
- 05:37 - 05:39
until about six months. Exclusive breastfeeding.
- 05:39 - 05:43
Because breastfeeding is supposed to continue until the child is two years old.
- 05:43 - 05:47
Some people support one year, but literature has supported up to two years,
- 05:47 - 05:52
and I usually say if a woman is encouraged to give a child good milk cow milk,
- 05:52 - 05:53
why not breast milk if she wants to.
- 05:53 - 05:55
So at six months of age,
- 05:56 - 06:00
breast milk is grossly insufficient to take care of a child needs.
- 06:00 - 06:01
So we need to advise
- 06:02 - 06:03
the parent now.
- 06:03 - 06:04
At this point,
- 06:04 - 06:07
I should have mentioned that introduction that this is
- 06:07 - 06:12
a lecture that is being targeted towards doctors towards
- 06:12 - 06:14
medical doctors who have just graduated from medical school
- 06:14 - 06:18
and who are being exposed to the community.
- 06:18 - 06:20
Health. Um specialisation.
- 06:20 - 06:22
So this is a lecture for doctors because
- 06:22 - 06:25
doctors are also instruments of public health advocacy.
- 06:25 - 06:30
Um, that being mentioned, we are going to.
- 06:30 - 06:32
So the complimentary feeling Why complimentary feeding?
- 06:32 - 06:37
Complimentary feeding is important because when you fail to introduce the
- 06:37 - 06:39
right food to each other at six months of age,
- 06:39 - 06:42
it can impact impact in fact, influence growth.
- 06:42 - 06:47
And you know, this is a period where, complementary, where food are a child,
- 06:47 - 06:50
you see that a child is a picky eater each other.
- 06:50 - 06:53
It's also food allergies, so it's a very crucial period.
- 06:53 - 06:56
You must give the child the right food. Present is the right way.
- 06:56 - 07:00
You must use attractive dishes, get a child stimulated child's interest,
- 07:00 - 07:05
and if you do not give iron rich complementary foods and iron fortified foods.
- 07:05 - 07:08
According to the European Society of Paediatric,
- 07:08 - 07:10
Gastroenterology and Hepatology,
- 07:10 - 07:14
this child will develop permanent
- 07:14 - 07:20
bring um, permanent brain challenges that may not be reversible.
- 07:20 - 07:20
In fact,
- 07:20 - 07:22
they have said that these these
- 07:22 - 07:24
challenges are often irreversible throughout life,
- 07:24 - 07:28
and that is why the 1st 1000 days of life have been focused on
- 07:28 - 07:31
and I'm moving on.
- 07:31 - 07:35
I would like to state that nutritional investment during the
- 07:35 - 07:38
1st 1000 days of life are very important in,
- 07:38 - 07:40
um, when $1.2
- 07:40 - 07:42
billion were invested in nutritional invention
- 07:42 - 07:44
interventions over a five year period,
- 07:44 - 07:47
the US got about $15.3 billion.
- 07:47 - 07:50
That's about 13 to 1 benefit to cost to issue.
- 07:50 - 07:54
So wherever we know that micronutrient supplements can lead to improved health,
- 07:54 - 07:55
fewer deaths we have.
- 07:55 - 07:57
We're going to be having fewer infant mortality
- 07:57 - 08:00
rates for your future neonatal mortality rate.
- 08:00 - 08:04
We are going to be having a, um, fewer population debts.
- 08:04 - 08:07
We're going to be having people that are operating at
- 08:07 - 08:11
the level of the maximal brain efficiencies and increased,
- 08:11 - 08:14
which will automatically result in result in
- 08:14 - 08:16
better productivity and increased future earnings.
- 08:16 - 08:19
So the dividends from investing in preventive nutrition,
- 08:19 - 08:22
especially in the 1st 1000 days of life, will help to reduce burden,
- 08:22 - 08:24
improve quality of life.
- 08:24 - 08:24
Now,
- 08:24 - 08:27
paediatric healthcare is an a pop appropriate segment
- 08:27 - 08:29
for the implementation of preventive nutrition behaviour.
- 08:29 - 08:34
Since eating professors are established very early in life,
- 08:34 - 08:39
I would also like to go through because this is a short masterclass.
- 08:39 - 08:41
I'll go to materials for further reading which
- 08:41 - 08:48
also serve as the bibliography during this period.
- 08:48 - 08:48
Now
- 08:49 - 08:51
the bibliography. I would give you
- 08:52 - 08:56
things for further reading. We have, um, the food association.
- 08:56 - 08:58
We have the fruit and grass, AJ.
- 08:58 - 09:01
I ate all stunting syndrome in developing countries
- 09:01 - 09:03
and we have the World Health Organisation,
- 09:03 - 09:07
the Food Association, the Food and Agricultural Association,
- 09:07 - 09:09
Food and Agricultural Organisation.
- 09:09 - 09:10
I mean the eff Oh,
- 09:10 - 09:14
and we have other materials from the Global Hunger Index and
- 09:14 - 09:18
the rest position papers from the European Society of Paediatric,
- 09:18 - 09:20
Gastroenterology and hepatology and nutrition.
- 09:20 - 09:27
That's the E s p g h a n Committee on nutrition. So we have lives, the benefits and our,
- 09:27 - 09:33
um I mean, we cannot attach specific nutrition timetables here. What a child.
- 09:33 - 09:35
It definitely has to be in the local context.
- 09:35 - 09:37
of the child's culture and environment.
- 09:37 - 09:41
So it is very important not to just put a one size fits all
- 09:41 - 09:46
plan or a one nutrition plant feet hole for all Children across different cultures.
- 09:46 - 09:50
It is important to know applied is to the to the child's culture.
- 09:50 - 09:52
You want to make sure that whatever that child seats
- 09:52 - 09:55
in the 1st 1000 days of like especially of course,
- 09:55 - 09:57
doing them, I mean the complementary foods.
- 09:57 - 09:59
This time you want to make sure that these
- 09:59 - 10:01
are foods that are very available to the child
- 10:02 - 10:05
that are stimulating to the child attractive to the child can be
- 10:05 - 10:10
easily gotten will not be of economic harm to the family.
- 10:10 - 10:12
Thank you for listening to this master class.