Why a child’s first 1,000 days are critical

For mothers and their babies, the days immediately surrounding birth are especially dangerous: three-quarters of all neonatal deaths happen during the first week of life, and one million babies die the day they’re born, according to a recent paper in The Lancet. At a high-level summit on maternal, newborn and child health, which wrapped up in Toronto Friday, there was much talk about how to make labour and delivery safer for these moms and babies. But beyond that, “people are talking about that critical 1,000-day window,” Dr. Joel Spicer, president of the Ottawa-based Micronutrient Initiative, told Maclean’s. The period that stretches from conception to a child’s first birthday can impact health for a lifetime. “If you ensure nutrition in that zone,” Spicer says, “you can do a lot of good.”

Spicer was a panelist in Wednesday’s discussion on nutrition, moderated by Ertharin Cousin, executive director of the U.N.’s World Food Programme (this panel was one of several at Stephen Harper’s summit that media were barred from attending). Of the six million children who die each year, he says, 45 per cent of these are related to undernutrition, a problem the Micronutrient Initiative is trying to address. In the last five years, it’s saved one million kids’ lives with vitamin A supplements, and protected 30 million newborns from permanent mental impairment through salt iodization, which addresses iodine deficiency.

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“Another key message that’s emerging out of this summit, is that survival is not enough,” Spicer emphasizes. Worldwide, 162 million children are stunted, he says, and “can’t reach their full potential.” Beyond that, almost two billion people around the world suffer from “hidden hunger,” and can’t get the vitamins and minerals required. In other words, it’s not just about filling empty bellies.

Spicer, whose organization received $75 million over five years from the 2010 Muskoka Initiative, praised Harper for the $3.5 billion in new funding for child and maternal health, pledged this week. “Canada has been quietly kicking ass on this, in terms of results achieved,” Spicer told Maclean’s, echoing a sentiment expressed by many others here at the summit: U.N. secretary general Ban Ki-moon, Dr. Margaret Chan of the WHO, and philanthropist Melinda Gates were all vocal in their praise of Canada’s investments. “Forget what political party you are, this is a story of Canadian values in action.”

Still, at the closing press conference, Harper was grilled on a perceived lack of accountability and transparency, even on this file. Access to contraception, and especially to abortion, remain contentious (some funding for family planning is included, but none for abortion, which Harper has called “too divisive”). As 2015 approaches, when the U.N.’s Millennium Development Goals are set to expire, the development community will be setting priorities for the years ahead. With maternal and newborn health as our signature issue, these issues won’t drop out of sight anytime soon.