The first 1,000 days: how early nutrition shapes children’s lives

What children eat in their earliest years shapes survival, learning and future productivity. Yet for many families, nutrition is constrained by habits, misinformation and limited choices. As Uganda confronts persistent malnutrition, there is growing recognition that change requires informed communities and stronger policies. Through a month-long campaign from April to May, New Vision in partnership with UNICEF and the Ministry of Health spotlight the challenges and solutions shaping children’s diets and their chances of a healthy start.

Transcript

SPEAKER_02 0:03

Welcome to the New Vision Daily podcast around Uganda. I'm Brazia Uthman. Today we look at how a child's plate in the earliest years of life shapes survival, learning, and future productivity. Across Uganda, many families continue to struggle with malnutrition, misinformation, and limited food choices. But health experts say the first thousand days of life offer a critical opportunity to secure a healthier future for children. Through a month-long campaign from April to May 2026, New Vision in Partnership with UNICEF and the Ministry of Health spotlight the challenges and solutions shaping children's diets and their chances of a healthy start. The first thousand days of life are a critical window that shapes a child's future. This period spans from conception until a child's second birthday. Nutrition during this time influences lifelong health, learning ability, and productivity. To help us understand why this period is so important, we begin with Laura Ahhomza, the senior nutritionist at the Ministry of Health. Once a woman conceives, health workers encourage her to attend antenatocare clinics at least eight times throughout pregnancy for routine checkups. During these visits, the mother receives tetanus vaccination, is assessed for malnutrition, and receives appropriate interventions. Some health facilities also provide maternal, child, and adolescent nutrition services. Here, mothers are given supplementary feeds to support the growth of the unborn child if they are not getting balanced nutrition at home. A well-balanced diet ensures the intake of essential nutrients such as folic acid, which supports the development of the spinal cord and helps prevent defects like spina bifeder in a baby. After birth, at regular intervals when a child is taken for immunization, health workers also monitor the child's growth. Where the growth is off track, health workers can advise on what can be done to reverse nutritional deficiencies before the child's second birthday. This is a window of opportunity that determines how tall or short that child can be. Esther Naluga, a clinical nutritionist, explains more about the importance of monitoring a child's nutrition and development during this stage.

SPEAKER_04 3:28

So we have, in simple terms, we have foods that we call energy foods. These are basically carbohydrates, matoke, rice, irish potatoes, pumpkin, and the likes. And then we have what we call bodybuilding foods or growth foods in simple terms. These are protein foods, eggs, milk, fish, chicken, ground nuts, beans, peas, soya. Those help the body to grow. And then we have what we call protective foods. These are mainly vegetables and fruits that supply micronutrients. Yes, those are the vitamins and the minerals that the body needs.

SPEAKER_02 4:07

Dr. Sabrina Chitaka, a pediatrician at Mulago National Referral Hospital, says adequate nutrition promotes optimal brain development, enabling the child to learn quickly. A well-nourished child, she adds, is more likely to grow into a productive adult capable of participating in economic activities. Let us now hear from Dr. Sabrina Chitaka.

SPEAKER_01 4:33

If you're talking children, you're thinking, what's the best fast food that a child should eat? And that's breast milk. It contains everything that a child would need, including proteins, water, vitamins, essential immunoglobulins. So babies start with breast milk. And as babies grow, we would like to see that they get enough protein in there, they have enough carbohydrates to give them energy, but also to have the necessary micronutrients and essential electrolytes.

SPEAKER_02 5:10

Exclusive feeding means breastfeeding for the first six months without giving additional foods, not even water, tea, glucose, other animal milk, infant formula, or porridge except medicine. Working mothers can achieve this through expressing breast milk using a breast pump and leaving the milk at home for the baby while they are away. Exclusive breastfeeding during the first six months benefits both the child and the mother. Initiating breastfeeding within one hour of birth strengthens the bond between mother and child. The practice is also believed to reduce the risk of death for newborns by 22%. The first yellowish milk, known as colostrum, contains antibodies that boost the baby's immunity. However, Uganda still scores low in initiating breastfeeding. The Uganda Demographic Health Survey 2022 report estimates that only 42% of Ugandan babies, that is, 4 of every 10 newborns, are breastfed within the first hour of birth. After the first hour, breast milk provides the necessary nutrients in the right quantities at the right temperature and is readily available. Exclusive breastfeeding also promotes development of the baby's brain while continuous suckling aids proper development of the jaw and facial structures. Eve Wilmore, the chief communication officer at UNICEF Uganda, now speaks about the importance of improving awareness around breastfeeding and child nutrition.

SPEAKER_00 6:56

So the main objectives of the campaign Nutrition for All, which is led by the Minister of Health with the support of UNICEF and partners, is to make sure that we all fully understand that malnutrition, undernutrition, as a lot of children in Uganda are suffering from, is not a fatality. We can avoid it. We have in Uganda all resources available. Nature is providing a rich diversity of nutritious food. We need to make sure that that food is being made available in a healthy way to the children of Uganda.

SPEAKER_02 7:40

Complimentary feeding begins at six months when semi-solid foods are introduced alongside breast milk, not as a replacement but as a supplement. At this stage, breast milk alone is no longer sufficient because the baby's nutritional needs increase with growth. Caregivers are encouraged to provide balanced meals that supply essential nutrients such as iron, protein, vitamins, and minerals. Foods should be introduced gradually based on age bands, that is, 6 to 8 months, 9 to 11 months, and 12 to 24 months. Additionally, food consistency, smooth, mashed, lumpy, and chopped, should match the child's age. This is critical to prevent choking while enabling infants to learn how to chew. Early foods may include millet porridge with milk and eggs, progressing to combinations such as maize porridge with milk and banana. During this period, the child's swallowing reflex develops and mothers are guided on how to introduce salt and manage test preferences. If children are introduced to too many sweet foods, they may grow up preferring only those ones. The same applies to salty foods. Clinical nutritionist Esther Naloga explains why caregivers should carefully manage children's food choices from an early age.

SPEAKER_04 9:18

Especially when we are bottle feeding. You want a child to finish a bottle. Already you're giving excess. A child is full, but you want to empty the bottle. Already you're starting with excess. And then we start complementary foods, and a child is you know taking a bottle and then eating a lot of carbohydrate. And in most cases, they're eating refined carbohydrate. Too much rice, too much chapati, too much potion. There, we are going to have a problem.

SPEAKER_02 9:49

Continued breastfeeding up to two years supports proper nutrition, strengthens immunity, and enhances emotional bonding between mother and child. Mothers are also trained on feeding schedules within 24 hours, including whether to breastfeed before or after meals. Silverfish or its powder can be mixed with beans, sweet potatoes, and a small amount of salt, then steamed and mashed. The meal can be divided into portions and fed to the child during the day. Caregivers are also encouraged to practice responsive feeding, identify any difficulties with chewing or swallowing, and adjust the food texture, feeding pace, or seek medical advice where necessary, children should be exposed to dietary diversity using locally available foods. Providing a diversified diet helps address micronutrient deficiencies often referred to as hidden hunger, which can negatively affect growth and development. These deficiencies are called hidden because they are not immediately visible, yet they significantly affect a child's development and can lead to stunting. Laura Ahumuza from the Ministry of Health explains why dietary diversity is essential for growing children.

SPEAKER_03 11:16

As a country, malnutrition remains a serious public health problem or issue. Much as we have made positive strides in bringing the rates down, they still need there is a lot that needs to be done.

SPEAKER_02 11:34

Poor nutrition during the first a thousand days can lead to malnutrition. This may manifest in various ways. The child may appear weak, struggle to play, and experience delayed brain development leading to learning difficulties. A key indicator of poor nutrition is stunting, a condition where a child is too short for their age. The Uganda Demographic Health Survey 2022 report reveals that approximately 2.4 million children under 5 in Uganda are stunted, representing a prevalence rate of roughly 23% to 26%. While this is a decrease from 29% in 2016, it remains a high public health challenge. Aside from stunting, poor nutrition puts children at risk of frequent illnesses such as diarrhea, pneumonia, malaria, and anemia that require repeated visits to health facilities. This affects not only the child, but also the caregivers' productivity as time and resources are diverted to health care instead of income-generating activities. Caregivers should seek help immediately if a child shows signs of poor growth, refuses to breastfeed, or shows signs of malnutrition such as weight loss, fatigue, dizziness, and muscle weakness. And finally, Eve Wilmore from UNICEF Uganda shares what more needs to be done to improve child nutrition awareness and support families across the country.

SPEAKER_00 13:26

We need to make sure that there is ownership about it and that good feeding practices are generalized so that children do not fall into malnutrition.