Early childhood development is crucial as the early years are when the brain develops most rapidly. Integrated programs that address both nutrition and stimulation can have stronger impacts on developmental outcomes than single interventions alone. The act of feeding provides many opportunities for positive adult-child interactions that are important for development, such as responding to cues, talking, singing, and playing, if feeding is interactive and age-appropriate. These interactions during feeding can directly contribute to early childhood development.

1. CGBI
Early Childhood Development:
The Role of Feeding
Miriam Labbok, MD, MPH,IBCLC
FACPM, FABM, FILCA
Professor of the Practice of Public Health
Founder and Director, CGBI
labbok@unc.edu

2. CGBI
Why do we Care about Early
Childhood Development?
UNICEF
http://www.unicef.org/earlychildhood/index_40748.
html
• Child’s Right: to develop as well as to survive. (CRC Articles 6, 27)
• High child mortality - 7.6 million children die
• >200 million children survive and do not reach full potential
• Result: ~20% loss in adult productivity
• Early years crucial - Equity issue
• Good nutrition/consistent loving care and encouragement ->
school achievement, health, higher earnings, reduced NCDs,
contribution to society
• Why?
– Increased brain development
– Increased personal sense of security and social skills
• Cost Benefit 1:4 or 5 - an investment, not a cost

3. CGBI
Advantages and challenges of integration:
Opportunities for integrating early childhood
development and nutrition programming
Ann M. DiGirolamo, Pablo Stansbery and Mary Lung'aho
and Black M, Dewey K. Annals of the NYAS, 2014
• A growing body of evidence supports the notion
that integrated programs addressing nutrition
and stimulation provide stronger impacts on
nutritional and developmental outcomes than
either intervention alone.
• Combined interventions can also lead to
increased access to services.
• Deterrents: Workload, communication and
coordination

4. CGBI
Raising a secure, productive and well-nourished
generation
Studies of Reunion behavior –
Lifelong outcome dependent on care-taker/child
interactions
Repair can occur!
Type of Parenting Child Later Adult
Secure: Consistent
responsiveness
Touches back,
independent
Well received, good
interactions
Avoidance: Consistent
lack of responsiveness
Ignores Poor social skills
and confidence
Ambivalent: Nervous,
inconsistent
Clingy and insecure Not seen as capable
and confident
Disorganized: Erratic,
abusive
Looks and backs
away
Social pariah
Mary Ainsworth, Dan Siegel

5. CGBI
Raising a secure, productive and well-nourished
generation
Studies of Reunion behavior –
Lifelong outcome dependent on care-taker/child
interactions
Repair can occur!
Type of Parenting Child Later Adult
Secure: Consistent
responsiveness
Touches back,
independent
Well received, good
interactions
Avoidance: Consistent
lack of responsiveness
Ignores Poor social skills
and confidence
Ambivalent: Nervous,
inconsistent
Clingy and insecure Not seen as capable
and confident
Disorganized: Erratic,
abusive
Looks and backs
away
Social pariah
Mary Ainsworth, Dan Siegel

6. CGBI
The Act of Feeding may be the majority of
adult infant/child interactions
Act of Feeding contributes directly to
ECD if the adult:
• Responds to cues
• Talks, Sings
• Plays
• Interactive
• Starts with Exclusive Breastfeeding
• Continues with age appropriate complementary
Feeding

7. CGBI
What I learned from my friends…
• Dr Angel R Colon
• Dr Patrice Engle
• Parents/Children everywhere
• THANK YOU!