– By Aashika Shivangi Singh & Aftab Shaikh
A Child’s Nutrition Story Begins Before Birth
When do we usually start worrying about a child’s nutrition? Often, when something becomes visible – a child is underweight, growth falters or wasting is detected. But by then, the story of that child’s nutrition may have been unfolding for months, sometimes since before birth.
In India, the scale of the challenge remains significant. NFHS-5 (2019–21) found that 35.5% of children under five are stunted, 19.3% are wasted and 32.1% are underweight. Anaemia affects 67.1% of children aged 6–59 months. These numbers tell us where children are today. They should also make us ask: how much earlier could we have acted?
The first 1,000 days: where prevention begins
The first 1,000 days from conception to a child’s second birthday are a critical period for growth and development. During these years, around 85% to 90% of a child’s cumulative brain development happens and nutrition has lasting implications for health, learning and wellbeing.
That makes nutrition more than a question of whether a child is gaining enough weight. It is about creating the conditions for children to grow, develop and learn to their full potential. And this story begins with the mother.
Before the child is born
Maternal nutrition is closely linked to child nutrition. Poor maternal nutrition and anaemia during pregnancy can affect foetal growth and birth outcomes. Supporting a child’s nutrition, therefore, cannot begin only after delivery. It must begin with supporting women before and during pregnancy.
After birth, feeding practices become equally important. WHO recommends exclusive breastfeeding for the first six months, followed by appropriate complementary foods alongside continued breastfeeding up to two years and beyond. Yet NFHS-5 found that only 11.1% of children aged 6–23 months received an adequate diet.
What a child eats matters but nutrition is never only about food.
The wider conditions that shape nutrition
Household income and food security, access to safe water and sanitation, healthcare, maternal wellbeing and caregiving practices can all influence nutritional outcomes. Repeated infections can further worsen nutritional status, creating a cycle in which illness and inadequate nutrition reinforce each other.
This is why the first 1,000 days should be seen not only as a period for treating malnutrition, but as a window for preventing it.
Where Anganwadis can make a difference
This is where India’s Anganwadi system becomes especially important. Anganwadi Services under Mission Saksham Anganwadi and Poshan 2.0 bring nutrition support, growth monitoring, early childhood care and education, and nutrition and health awareness closer to children, pregnant women and mothers.
Anganwadi Workers are often among the frontline workers closest to families. They can help identify nutritional concerns, counsel caregivers, support feeding practices, monitor growth and connect families to health services. The national community-level protocol also provides for screening, nutritional management, referral and follow-up through the Anganwadi system.
Early action can change outcomes and that has been reflected in the case of four-year-old Sourabh Dewangan from Chhattisgarh, who was identified as severely wasted through growth monitoring at his Anganwadi Centre where the worker was Geeta Yadav, with her support and awareness, community-based care, medicines and health check-ups, take-home rations, home visits and counselling for his mother, he recovered to normal nutritional status within five months.
His story shows what is possible when identification is connected to timely support.
The cost of waiting
The cost of delayed action is not simply a number on a growth chart. It can mean missed opportunities during a period when growth and development are changing rapidly.
As India observes Nutrition Month, perhaps the question we need to ask is not only, “How do we treat a malnourished child?” but also, “What would it take to ensure fewer children become malnourished in the first place?”
Because a child’s nutrition story does not begin when malnutrition becomes visible. It begins before birth and prevention must begin there too.