Nurturing care during the first 1000 days of life : a systematic review
Mputle, Lizzia Doreen Palisa
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Parents are the key role players in ensuring favourable child wellbeing and healthy development, but a broad range of governmental programs also play a critical role. Previously children aged 5 years and primary school going were targeted for interventions and development in communities was gauged with this age group, many times neglecting the fact that for these children to reach that milestone there should have been suitable brain and cognitive development which takes place during the first 1000 days. Children are dependent on the care of adults in their environments and these young children’s security in relationships should be strengthened by improving caregiver’s responsiveness and reducing their stress. The earliest social experiences in a child’s life can shape their developing neurological and biological system, such as exposure to toxic stress which may distort their response to stress later in life. Early interventions have been identified as having the potential to reverse or buffer the effect of chronic stress due to the plasticity of the developing brain. Challenges have been identified, most especially in low-income countries, that wasting affects most children under five years of age and it carries severe health consequences; hence infants are found to be extremely vulnerable to wasting, while stunting generally increases with age from early childhood to around 24 months to 35 months. It is therefore a result of poor nutrition in the early life, which may have long-term consequences and not only for the child but also the child’s family, the child’s community and even the child’s next generation. Exclusive breastfeeding is an available strategy to accomplish normal growth regardless of these disadvantages as well as prevention of inappropriate bottle use and introduction of solid food intake before the age of 4 months. In many vulnerable families, capabilities of adult caregivers have to be built in order to achieve good outcomes for the children in their care. This should be done through supporting the development of children’s and caregiver’s self-regulation skills, mental health and executive functioning. In addition, there has to be some sort of strategies to improve the economic and social stability of the family, thereby maximizing the health benefits that will positively impact on young children across their life-course. Health aspects, provision of good nutrition, responsive care, safety and security as well as early learning are all the domains that make up the nurturing care framework, when implemented together they can ensure that children achieve favourable development outcomes. Key role players should be involved in ensuring the implementation of the nurturing care in the first 1000 days of life in communities across the world.
- Health Sciences