IN 2013, undernutrition caused 45 percent of deaths of children under five years old in the Philippines, according to the non-government organization Save the Children Philippines.
“Poor nutrition in the first 1,000 days of a child’s life can also lead to stunted growth, which is irreversible and associated with impaired cognitive ability and reduced school and work performance,” the United Nations Children’s Fund added.
According to the 2015 updating of the National Nutrition Survey, 12.7 percent of children 0-5 months old in the country were stunted, the rate rising to 17.3 percent for those 6-11 months, 36.2 percent for one-year-olds, and 38.4 percent for two-year-olds, showing the cumulative effect undernutrition has on children’s development and underscoring the need for early intervention to prevent stunting.
For a more holistic effort to provide health, nutrition, education and social welfare services in the first 1,000 days, the National Nutrition Council (NNC) is now implementing the Early Childhood Care and Development Intervention Package for the First 1,000 Days (ECCD IP/1000).
It is being implemented in 10 provinces from 2016 to 2018.
“The first 1,000 days—from the period of conception up to the first two years of life—is the window of opportunity for nutrition intervention. If you give intervention during this period, the child can still catch up in his cognitive development,” said NNC 7 nutrition program coordinator Dr. Parolita Mission.
The 10 priority provinces are Cebu, Pangasinan, Quezon, Camarines Sur, Iloilo, Negros Occidental, Leyte, Zamboanga del Sur, Davao del Sur and Sulu.
In Cebu, the three focus areas for the ECCD IP/1000 are Santa Fe, Dalaguete and Tuburan.
Intensifying efforts
The ECCD program is not new. The law ordering the institution of a national system for early childhood care and development to ensure the delivery of services to children from conception to age six, was passed in 2000 yet.
Mission said the ECCD IP/1000 just gives emphasis on the first 1,000 days.
“We give emphasis on monitoring, reaching out to the household level because some families have poor health-seeking behavior. They don’t go to the health center. So we capacitate our barangay health workers and barangay nutrition workers to monitor all children below two years old and all pregnant and lactating women, to ensure that they are covered in the immunization for the child, and all health services due in their age group, and pre-natal care for pregnant women,” she said.
National Nutrition Surveys show that the prevalence of nutritionally-at-risk pregnant women has stayed unchanged at 24-26 percent since 2008, which could also affect the nutrition of the fetus.
In Cebu, the package targets 5,451 pregnant women, 4,668 lactating women and 8,401 infants 0-23 months old, said Retz Pol Pacalioga, NNC 7 ECCD F1K provincial nutrition coordinator.
The P7,174,354 budget for the NNC component of the package in Cebu goes toward, among others, mothers’ classes and aid so they can make home gardens in the local government unit level.
This is aside from the interventions of other agencies under this package, Mission said.
The existing mothers’ classes now use the Pabasa sa Nutrition module, where a group of 10 mothers discuss how to interpret nutrition concepts in their life.
“And in this ECCD program, there is already a recipe trial, so they will know how to prepare low-cost but nutritious food,” she said.
Breastfeeding
At the Department of Health 7, medical officer III Dr. Hayce Famor-Ramos said, “In the nine months of pregnancy, the health centers already have a lot of programs: the pre-natal, post-natal exam, vitamins, free vaccinations, birthing homes.”
What may need more promotion is feeding after childbirth.
“I am promoting breastfeeding in the workplace,” said Ramos, who was expressing breast milk for her three-month-old baby during our interview.
The World Health Organization recommends exclusively breastfeeding babies for the first six months. After six months, continued breastfeeding is recommended with complementary solid food up to two years old or beyond.
National Nutrition Surveys show that exclusive breastfeeding in the first six months of life slid from 52.3 percent in 2013 to 48.8 percent in 2015.
Then, when infants reach 6-23 months, only 15.5 percent of them receive the minimum acceptable diet, meaning the right amount in the “consumption of foods from four of a group of seven groups that include grains, roots and tubers; legumes and nuts; dairy products; flesh foods (meat, fish, poultry and liver/organ meats); eggs; vitamin-A rich fruits and vegetables; and other fruits and vegetables.”
Express and storage
Under the Expanded Breastfeeding Promotion Act of 2009, Ramos said, nursing mothers get a minimum of 40 minutes lactating break per day, excluding the lunch break.
Ramos said the breast milk will be good for two weeks if frozen in the freezer portion of a one-door refrigerator. If frozen in a two-door refrigerator, where the freezer is separate from the refrigerator, the milk will last six months.
“If you don’t put it in the freezer, and instead put it in the refrigerator, the milk is good for eight days. But it’s best consumed in three-five days,” she said.
From womb to two, a child’s fate in life is cast. (CTL)