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This post originally appeared on the 1,000 Days blog.
 
Consensus that good nutrition is a critical aspect of good health, especially during the first 1,000 days of life, is growing. As more and more evidence points to the important role of nutrition for the health of women and children, greater attention needs to be paid to the barriers to mainstreaming maternal and child nutrition services as part of routine clinical care.
 
One such barrier is the lack of evidence-based, standardized measures for measuring growth and development available to healthcare professionals. At present, there is huge diversity in the numbers and types of clinical tools used to measure fetal and newborn growth across the world, within countries, and even within facilities. It is not uncommon for a woman to be told their baby is small by one doctor and normal by another on the same day of care. The consequences of this are many. Without up-to-date and evidence-based tools, healthcare professionals are not able to make the most effective health and nutrition recommendations to their patients. Additionally, being told different things by different clinicians can undermine trust between women and their doctors.
 
New evidence from the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) is poised to fill this gap.
 
The INTERGROWTH-21st Project studied growth and development in eight geographically and ethnically diverse countries, involving nearly 60,000 mothers and babies. Through rigorous monitoring of growth in healthy mothers across the study sites, findings from the INTERGROWTH-21st Project confirm that babies can grow similarly when mothers are well nourished and have access to evidence-based clinical care. The INTERGROWTH-21st Project has provided, for the first time, an evidence-based, global indicator for optimal growth from conception to birth against which all babies can be compared. These indicators complement the WHO Child Growth Standards, a landmark achievement in the field of health and nutrition research. With adoption in over 120 countries, the WHO Child Growth Standards have given healthcare providers an international benchmark of “good growth” that has been used to compare nutrition status of populations within and between countries, to great effect.
 
The INTERGROWTH-21st Project also provides compelling evidence that the conditions required to achieve optimal fetal growth are known and achievable, and that large improvements in fetal growth are possible within a generation. For example, the new growth standards were informed by women who met certain criteria of good health, including having exclusively breastfed their children for the first six months of their life – a known best practice. While some reasons for poor growth are due to factors beyond a healthcare provider’s control, such as chromosomal or congenital abnormalities, others can be reduced or eliminated through a country’s investment in maternal and child health. In particular, increasing access to and quality of healthcare systems that mainstream an awareness of nutrition practices for women before, during and between their pregnancies is a key way of improving the growth and development of their children.
 
The new fetal and newborn growth standards will be as applicable in settings where women are under-nourished and children are wasted and stunted as they are in settings where women and children are over-nourished. This is of particular importance in settings where low-nutrient and high-calorie foods are becoming more and more accessible, greatly increasing the number of women who are overweight and obese entering pregnancy and who are then at greater risk of pregnancy complications such as preeclampsia and gestational diabetes.
 
A recent convening of maternal and child health experts, leading world economists, and political leaders from dozens of countries at the Emerging Markets Symposium re-affirms the importance of prioritizing maternal and child health and nutrition, implementing standardized evidence-based healthcare for mothers and newborns, and the universal adoption of the INTERGROWTH-21st Project’s new global indicator at birth to capture differences in population-level nutritional and environmental exposures during pregnancy.