Nutrition On The First 1000 Days Of Life Determinate The Nutritional

Status And Development Children

Miftakhur Rohmah
Institute of health Science Surya Mitra Husada Kediri Midwifery Division
m1111ftaa@gmail.com

ABSTRACT
Growth and development children for 1000 first day of life requires the nutritional intake from
the mother, either consumed by the mother or from mobilization of saving mother, if the intake of
nutrients from mother to fetus is less, then the fetus will make adjustments, because fetus can
adaptable easy. Indoneasian have a double nutritional problems, on the one malnourished and on the
other have excess nutrients. Based on the result of Riset Kesehatan Dasar (Riskesdas) in 2010 the
percentage of low birth weight in Indonesia amounted to 8,8 percent, children under five years
stunting of 35,6 %, and wasting for children under five years 13,3 %. This study is a literature review
that provides information abaout nutrition in the fisrt 1000 days of life determines the nutritional
status and early childhood development. Source to do this literature review included studies os
systematic searches of computerized database (Google scholar, Pubmed, and EbscoHost). Writing
asticles using the format of writing Vancouver. Cognitive development abd physical of a child
affected by the 1000 first day of life, from ceonception conception until a child is two years old are
influenced by biological factors, such as maternal nutrition during pregnancy, gestational age, birth
weight, duration of breastfeeding, child malnutrition, infectious diseases in the future children and
psychosocial factors, such as economic status, parental education, and the environment. The quality of
child development can be enhanced with a variety of businesses both the parents, society and
government. Various factors, both genetic and environmental influences that are so pluralistic
development of the child since the prenatal, perinatal and postnatal that is during the first 1,000 days
of a child's life. In conclusion, achieving optimal child development depends on biologiknya potential,
biological potential level of achievement is the result of the interaction of a variety of interrelated
factors, especially during the first 1,000 days of a child's life.
Kata Kunci : the first thousand days of life, nutritional status, development

INTRODUCTION growth and impaired metabolism in the body.

Maternal and child nutrition has ben on
the global agenda as central to health,
sustainable development, and progress in low
and middle income countries. The recent
lancet Nutrition series, the global nutrition
report and the post MDG goals set by the
World Healthy Assembly highlight the need to
addres the global burden of maternal and
childhood under and over nutrition and for
scalling up nutrition action. 11
Based on the result of Riset Kesehatan
Dasar (Riskesdas) in 2010 the percentage of
low birth weight in Indonesia amounted to 8,8
percent, children under five years stunting of
35,6 %, and wasting for children under five
years 13,3 %. 3
The adverse effects caused by
nutritional problems mentioned above in the
short term is the disruption of brain
development, intelligence, impaired physical
While in the long term bad consequences that
will be caused is a decline in cognitive ability
and learning achievement, the decline in
immunity so easily hurt, and the risk for the
emergence of degenerative diseases. All this
will degrade the quality of Indonesian human
resources, productivity, and competitiveness
of the nation.1
Cognitive development and physical of
a child affected by the 1000 first days of life,
from conception until a child is two years old
are influenced by biological factors, such as
maternal nutrition during pregnancy,
gestational age, birth weight, duration of
breastfeeding, child malnutrition, infectious
diseases in the future children and
psychosocial factors, such as economic status,
parental education, and the environment.1
Research in India aimed to estimate and
assess determinants during pregnancy and
after childbirth were associated with the

Nutrition of the first 1000 days of life Page 1

incidence of disease experienced by children
during the first 1,000 days of life . Result is
estimated that 14.8 diseases / child-years with
gastrointestinal disease 20.6% and 47.8% of
respiratory infections. Reduced rates of
hospitalization in infancy from 46/100 16/100
children become child-year-year in the second
year
Factors associated with low birth weight
are: average birth weight of 2.9 kg and the
average gestational age of 39, 6 weeks,
preterm birth less than 37 weeks (OR 3.31),
less than four antenatal care visits (OR 6.88)
and anemia was defined as hemoglobin <10 g /
dL during pregnancy (OR 2.36).
Nutritional Status seen from
anthropometric measurements obtained from
414 children at age 24 months showed that
153 (37%) of children with stunting totally 39
(9.4%) children who have a thin body and 125
(30.2%) children less weight. The average
height and weight level monthly increase was
1.35 cm and 290 g, respectively, for the first
730 days of follow-up, related to perinatal
mortality reported seven deaths, five were
spontaneous abortions and stillbirths two ,
Nine deaths were reported during the 2 years
of follow-up; three children died of diarrhea,
two due to lower respiratory infections, two
due to congenital metabolic conditions and
two due to unknown causes.
Antenatal care is important for
screening of high-risk mothers, monitor
weight gain during pregnancy, screening for
anemia, providing nutritional supplements that
are essential for good pregnancy outcomes,
and help to reduce or prevent maternal and
infant complications and death.
Growth and development during the
first 1,000 days of life require the nutrition of
the mother, either consumed by the mother or
from the mobilization of savings mother, if the
intake of nutrients from mother to fetus is less,
then the fetus will make adjustments, because
the fetus is easy to adjust. Malnutrition in a
thousand days of life, has three risks, namely
the risk of first occurrence of non-
communicable diseases or chronic, the risk of
a second when the brain affected will
experience obstacles cognitive growth, making
it less intelligent and competitive, and the risk
of all three disorders height growth that has
short risk.4
Growth and development during the
first 1,000 days of life require the nutrition of
Nutrition of the first 1000 days of life
the mother, either consumed by the mother or
from the mobilization of savings mother, if the
intake of nutrients from mother to fetus is less,
then the fetus will make adjustments, because
the fetus is easy to adjust. Malnutrition in a
thousand days of life, has three risks, namely
the risk of first occurrence of non-
communicable diseases or chronic, the risk of
a second when the brain affected will
experience obstacles cognitive growth, making
it less intelligent and competitive, and the risk
of all three disorders height growth that has
short risk.4
METHOD
This study is a literature review that
provides information about the stimulation that
should be done on the first 1,000 days of life
as a determinant of the nutritional and
development children. Source to do this
literature review included studies of systematic
searches of computerized databases (Pubmed,
Proquest, EbscoHost dan google scholar) in
the form of research journals totaling 7
journals, 1 guidelines. Journal of Research in
use from 2010 to 2015, conducted in the
Philippines, India, Indonesia, Brazil, Austria
and Poland. The study of these studies in
quantitative analysis. There is one journal with
the respective analysis methods Study, 2
journal cohort method, two journals using a
Randomized Control Trial (RCT) and two
journals systematic review and one guideline
of save the children. Writing a scientific article
uses bibliography vancover writing.
RESULT AND ANALYSIS
Early pregnancy is zero attention to
children, particularly in maintaining good
nutrition assuredness optimally, until at least
the next 1,000 days. Basically in 1000 the
beginning of life, growth and development of
children takes place rapidly. While still in the
womb, for example, the fetus grows rapidly
until late born. At that time, the fundamentals
of its development was already formed.
Pregnancy and infancy is a critical period for
brain development. Mothers and babies need
good nutrition to build the basis or foundation
of cognitive abilities, motor, and social child.
Success in school and work productivity in the
future. Children with brain development is not
perfect at the beginning of life are at risk of
suffering from a neurological disorder, the
achievement of low achievement at school,
Page 2
low skills and parenting is wrong with their
child, which in turn will contribute to the
quality of the generation of the low in the
future. 4
According victoria et al. Describe
comparison of growth patterns of children in
54 countries using the WHO standards, shows
that the failure of growth in the early growth
of children is more severe than is suggested by
previous analysis by NCHS (natonal centers
for health statistics). This study explains that
the need for nutritional growth and
development during the period of the window
of opportunity is defined by the pregnancy and
the first 2 years of life. Including the
prevention of newborn babies is low and that
sesuei feeding practices for infants.2
Nutritional interventions can doing at
the first 1000 day of life: 4
a. Pregnancy
1. Iron folate or maternal
suplementtation of multiple
micronutrients
2. Calcium supplementation
3. Iodized salt
4. Interventions to reduce indoor air
pollution and tobacco use
5. Deworming
6. Intermittent preventive treatment for
malaria
7. Insecticide-treated bednets
b. Newborn
1. Immediate and exclusive breastfeeding
2. Delayed cord clamping
3. Vitamin suplementation
c. 0-6months
1. Exclusive breastfeeding
2. Hand washing or hygene
3. Conditional cash transfer (with
nutrition education)
4. Insecticide-treated bednets
d. 6-24 Monhts
1. Continued breastfeeding
2. Complementary feeding
3. Preventive zinc suplememtation
4. Zinc in management of diarrhea
5. Vitamin a supplementation
6. Iodized salt
7. Multiple micronutrien powder
8. Hand washing or hygene
9. Treatment of severe acute malnutrition
10. Deworming
11. Iron suplementation and fortification
Nutrition of the first 1000 days of life
12. Conditional cash transfers (with
nutrition education)
13. Insecticide-treated bednets
A. Identification Prevention and Treatment
of Iron Deficiency During 1000 First Day
of Life.5
Iron deficiency is a global problem
throughout the journey of life,. Maternal
iron deficiency during pregnancy may
affect the subsequent descent to iron
deficiency in infancy, with sequelae
have a lifelong impact. This review
explores iron status along this "first
1,000 days" from pregnancy through
two years, covering the role of iron and
epidemiology of iron deficiency, and
consequently, identification,
intervention and the rest of the research
gaps.5
1. Iron Metabolism
Iron is one of the most important
micronutrient for the human
population, given the central role in
key biological processes. One of the
main process is that the tissue
oxygenation, which is carried by red
blood cells (RBCs); the generation of
red blood cells in need of
hemoglobin, the iron is a key
component. The new red blood cells
were also made to replace lost red
blood cells from normal turnover,
shed (the cells of the skin or from
intestinal lining) or by bleeding. A
situation which requires an increase
in red blood cells (such as tissue
mass increases from fetal or infant
growth) would consequently increase
the need for iron. function).
2. Needs during pregnancy and
lactation
Iron is essential during
pregnancy are given as cells and
tissues grow rapidly which affects
the fetal growth. Pregnancy has iron
needs in the range of 600-800 mg.
Nearly 300 mg of iron is needed only
for the fetus, at least 25 mg for the
placenta and nearly 500 mg for an
increase in the volume of red blood
cells. 800 mg of iron-related
pregnancy is a requirement over and
above 230 mg of iron will be needed
Page 3
 woman even if she is not pregnant,
and 150 mg that he might lose
through loss of blood during
childbirth.
3. Needs in infants 0-24 months
Iron needs for infants under six
months of age are generally not well
defined, because it is difficult to
estimate because the needs in the
context of exclusive breastfeeding is
still given. In addition, during the
first four to six months of age, most
babies get iron from birth were born,
which is largely accumulated during
the last 10 weeks of pregnancy.
Although the baby does not receive a
large amount of iron through breast
milk (iron concentration <1 mg / L,
equivalent to <0.5 mg per day for
infants, babies are able to absorb
most of this iron. For this reason, an
iron supplement is usually not
recommended for a term breastfed
infants under six months. However,
in preterm and low birth weight
babies born with lower birth iron
supplementation in the range of 2-4
mg / day is recommended to avoid
iron deficiency.
4. Due to iron deficiency during
pregnancy
Iron deficiency during
pregnancy can have a severe
consequence, not only for the mother
but also for her baby. Low iron and
low intake during pregnancy not
only cause anemia, associated with
weakness, fatigue, also interfere with
cognitive development and reduced
immune response, but also can
increase the risk of complications of
labor and perinatal maternal
mortality. Maternal iron deficiency
has also been implicated as a risk
factor for premature birth, small for
gestational age and neonatal death.
This shows the importance of iron
for fetal brain development, iron
deficiency during pregnancy also
increases the risk of anemia and iron
deficiency during lactation.
5. Due to iron deficiency in infancy 0-
24 months
Nutrition of the first 1000 days of life
Infants are vulnerable to the
effects of low iron status, even
before the first birth, both iron
deficiency and an increased risk of
decline in cognitive and
psychomotor development in
infancy. Iron deficiency develops
later in infancy and causes anemia
and iron deficiency has also been
associated with cognitive
impairment, developmental
behavioral and motor iron deficiency
in children has also been associated
with blood lead levels high, with
some evidence of the causative link,
where iron deficiency makes
children more susceptible to blood
lead levels higher..
6. Interventions during pregnancy,
lactation and infancy 0-24 months.
Interventions The most common
and effective way to tackle iron
deficiency in pregnant women is
supplementation with iron, often in
combination with folic acid, iron
supplementation may be given
before conception to ensure the
prevention of iron deficiency in the
mother..
Babies, especially premature or with
low birth weight babies, will also benefit
from iron supplementation, it is
recommended regularly for high-risk
populations, the iron supplementation
baby in often given in liquid form has
been shown to be effective in reducing
anemia and iron deficiency. However,
these drops have some drawbacks cause
side effects in infants are gastrointestinal
in administration by overdosing.
B. Giving iodine supplementation during
pregnancy and effects on cognitive
development.6
Maternal Hypothyroxinemia and
hypothyroidism due to iodine deficiency
has been shown to affect the development
of the newborn. Iodine has long been an
important element, severe iodine
deficiency during pregnancy is the cause
of congenital hypothyroidism resulting in
cretinism, iodine deficiency ranks third on
the list as a cause of child developmental
disorders. According to WHO, there are
32 countries that experienced mild to
Page 4
 moderate iodine deficiency and it is a
public health problem. Iodine deficiency
is not only a health threat in developing
countries, but also in developed countries,
mainly in Europe.
Recent reports suggest that iodine
deficiency has been repeated in countries
where it has been under control before,
such as in the United States, Australia,
New Zealand, and the United Kingdom.
Preliminary studies indicate
supplementation to the mother giving out
a positive impact on the development of
children living in areas with severe iodine
deficiency. Research in Zaire showed that
in children aged 6 years of mothers given
iodine supplements have developmental
scores 10 points higher than women who
were not given iodine supplements.
Studies in China show the 15-point
difference in the development of children
age 2 years among women given iron
supplements with those not given.6
WHO guidelines suggest to provide
iodized salt, its availability is 90% of
households have access to iodized salt
and will provide enough iodine for
women during pregnancy.
Research conducted in Spain is a
country that is known to mild iodine
deficiency, children aged 18 months than
women given supplements of iodine in
the three groups, given in early pregnancy
(4-6 weeks, n = 13), pregnancy (12- 14
weeks, n = 12) and after birth (n = 19)
tested the development of intelligence
using a scale Brunet-Lezine shows the
group exposed longer to the
supplementation of iodine has a supreme
intelligence which is (101 vs 92 vs 87),
with p <0, 05.
In a research study of other children
of the group of women who received
supplements of iodine from the first
trimester of pregnancy until the next (n =
133) compared with children aged 2 years
of mothers who did not receive the
supplement iodine (n = 61) with Bayley
scale assessment showed children of
mothers who were supplemented with
iodine has a 6.1 index points higher
psikomotornya development with P <0:02
compared to children of mothers who
were not given iodine supplements.
Nutrition of the first 1000 days of life
C. Vitamins for the first 1,000 days of life.7
As a basis for a healthy life begins
during pregnancy and in early infancy,
adequate nutrition during this period is
very important. With a variety of
functions in the body, vitamin important
as the specific needs in the growth and
development during pregnancy,
breastfeeding and baby. 7
1. Vitamin A
According to WHO estimates
worldwide in 2009, a vitamin
deficiency affects approximately 190
and 19 million children and pregnant
women, respectively, especially in
areas of Africa and South Asia. it is
the main cause xerophthalmia, night
blindness, and anemia. In addition, it
is important for immune function and
mucosal integrity, and inadequate
persediaann is associated with a higher
susceptibility to intestinal and
respiratory infections.
Through its role in gene
regulation, vitamin A is involved in
fetal development, organogenesis, the
formation of limbs, and body
symmetry.
2. Vitamin D
Vitamin D has the effect of
modulating immunity and regulator of
gene expression. In early life, the role
of vitamin D in bone formation is
obviously very important. As pregnant
women are often suboptimal and not
enough to ensure adequate
concentration in breast milk, the baby
is recommended supplementation with
10 mg / d.
3. Folate
Folate is one of the first vitamin
that appear in thought to the context in
pregnancy and fetal development
because of its role in the prevention of
neural tube defects.
4. Important Vitamins in pregnancy and
infancy.
Vitamin has an important role and
are needed in pregnancy and infancy,
pregnancy, breastfeeding and
childhood vulnerable to vitamin
deficiencies, vitamin intake is
inadequate during pregnancy and
lactation making supplies of vitamins
in the body of the mother becomes
Page 5
 less so mengakibatnya nutritional
status is low and konsukuensinya
detrimental to his own mother and the
fetus. Determining micronutrient
status and allow the baby in the
formation of inventories during the
first four to six months of life.
5. Increase intake of Vitamin early in life
Optimal vitamin intake is
especially important in life because as
a basis for future life and prosperity,
efforts to increase vitamin intake
during pregnancy and infancy should
be a top priority in public health.
In general, pregnancy is a period which is
supposed to make women more aware of
health that allow them to accept changes
in lifestyle and diet also increase the
intake of vitamins during pregnancy. Food
fortified with various vitamins from other
sources for women who are unwilling and
unable to folate supplements such as in the
case of a state that is relevant to low
income and low socioeconomic status.
D. Exclusive Asi effect in the Growth and
Development of Children.
Effect of feeding on infant health
and development, observation of the
seven last decade when the baby is
breastfeeding provide useful evidence
for the cognitive development of
children impact of breastfeeding
provide long-term benefits for
children's mental health. Breast milk
is a rich source of fatty acids and
bioactive components that are
important in brain development. Two
fatty acids fatty acids associated with
the development of nerve cells, the
retina and the brain: docosahexaenoic
acid (DHA) and arachidonic acid
(ARA). Both are present in breast
milk, but absent from infant formula
and cow's milk. Both have also been
shown in experiments to improve
eyesight and some motor response in
infants and children.8
Many of the results from clinical
trials showed that children who were
breastfed had the highest score of
Nutrition of the first 1000 days of life
cognitive function compared with
children who received formula milk.
Research in Krakow Poland with
468 infants (with gestational>
38minggu) with a prospective cohort
assessment of cognitive function with
psychometric test.
The result of children who were
breastfed until 3 months have an
average IQ of 2.1 points higher than
that of other children (95% CI: 0.24 to
3.9), the children were breast-fed for
4-6 month had 2.6 points higher (95%
CI: 0.87 to 4.27), while children who
breastfeed for longer> 6 months
increased by 3.8 points (95% CI: 2.11
to 5.45 ). The study provides
recommendations on the WHO
experts about 6 months of exclusive
breastfeeding.
The first 1,000 days of a child's
life provide opportunities for prenatal
care and interventions in early life to
boost growth. Breastfeeding up to two
years or more is a potential strategy
that provides protection to the child
after the second year of his birth,
breast milk is a source of immune
factors, nutrients and micronutrients
that are not available on the food that
is generally given after 2 years of life,
particularly in countries with low
income.9
CONCLUSION
Nutrition has an important role in national
economic development, the condition of
malnutrition will result in a lower level of
productivity of human resources in the
country.
Nutrition and health problems are not
caused primarily by genetic factors but
because of environmental factors that can be
fixed with a future focus on the first 1,000
days of life. Improve nutrition in the first
1,000 days of life will support the growth and
development of the fetus, infants, and children
up to age 2 years.
Efforts or interventions to improve
nutrition in the first 1,000 days of life which is
Page 6
focused on pregnant women, nursing mothers http://dx.doi.org/10.1016/j.jtemb.2012.03.
and infants aged 0-23 months. 10 005
7. Elmadfa I, Meyer A L. Vitamins for the
The author realized in this article there are first 1000 days: Preparing for Life. Int. J.
many shortcomings because of limitations in Vitam. Nutr. Res. 2012;82(5):342−7.
assessing the author, given the many factors 8. Jedrychowski W, Perera F, Jankowski J,
that influence the growth and development of Butscher M, Mroz E, Flak E, dkk. Effect
children in the first 1,000 days of life. of exclusive breastfeeding on the
development of children’s cognitive
function in the krakow prospective birth
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