Children's First 1000 Days

1. A M A D O R . P A R A W A N M . D .
Health and Nutrition Advisor
Save the Children Philippines
Improving Nutrition during
Pregnancy and the Involvement of
NGOs

2. Presentation Outline
I. BACKGROUND
• WHO Framework on Stunting
• Maternal Nutrition Status
II. PREGNANCY NUTRITION INTERVENTIONS
• General Nutrition Guidelines
• Trimester-Specific Pregnancy Nutrition
III. Recommendations and Suggestions for the Involvement of
NGOs to Improve Nutrition during Pregnancy and Maternal
Nutrition

3. Health & Nutrition Global Initiative - Thematic Strategy Webinar, March 2015
WHO Framework on Stunting

4. Before pregnancy:
 Importance of proper nutrition for the maintenance of normal body fat,
hormone levels and fertility
 Intra-uterine Growth Retardation (IUGR)
During pregnancy, malnutrition can lead to:
 growth retardation, low birth weight, birth defects, premature
birth, spontaneous abortion, stillbirth
 increase child’s risk of developing chronic diseases such as
cardiovascular disease, high blood pressure, diabetes mellitus,
obesity and osteoporosis
 future food preferences of an infant
Maternal Nutritional Status

5. • The weight of an infant at
birth: about 25% of total
weight gain during pregnancy
Weight gain during pregnancy
Healthy, normal-weight
woman should gain 11–16 kg
(25–35 lbs) during pregnancy
•Rate of weight gain is as
important as amount
•Little gain is expected in the first 3
months (1st trimester), usually
about 1–2 kg (2–4 lbs)
•In the 2nd and 3rd trimesters, the
recommended maternal weight
gain is about 0.5 kg (1 lb)/week

6. PREGNANCY NUTRITION INTERVENTIONS
General Nutrition Guidelines
- Provide comprehensive dietary guidance throughout
pregnancy, emphasizing essential nutrients, food
groups, and portion control.
- Promote a balanced diet rich in fruits, vegetables,
whole grains, lean protein, dairy products, and healthy
fats.

7. Trimester-Specific Pregnancy Nutrition Recommendations
First Trimester (Weeks 1-12)
Initial Prenatal Checkup
• Schedule within the first trimester, ideally weeks 4-8
• Utilize DOH-accredited health centers or birthing facilities for free prenatal
care.
Essential Vitamins
• Start prenatal vitamins containing folic acid (400 mcg) as soon as possible.
• Consider Maternal, Newborn and Child Health and Nutrition, and Family
Planning programs for free prenatal vitamins if eligible.
Water Intake
- Aim for at least 8-10 glasses of water daily, considering locally available options
like fresh coconut water or binagoongan (pandan water).

8. Balanced Diet
Focus on locally available and affordable nutrient-rich foods:
• Fruits and vegetables
Aim for 5 servings daily, highlighting guavas, papaya, bananas,
leafy greens (kangkong, malunggay), and citrus fruits (santol,
calamansi)
• Whole grains
Choose brown rice, kamote, whole-wheat pan de sal, or banana cue
for sustained energy
• Lean protein
Include pork adobo, fish sinigang, chicken tinola, and mung bean
soup for fetal development
• Dairy products
Opt for low-fat yogurt, kesong puti, or fortified carabao milk for
calcium and vitamin D
• Healthy fats
Include avocado, banana heart, nuts, and coconut oil for essential
fatty acids

9. Second Trimester (Weeks 13-27)
Increased Calorie Intake
• Gradually increase calorie intake by 300-500 calories per day above pre-
pregnancy needs
• Consider adding healthier snacks like banana chips, boiled peanuts, or
suman sa latik
Protein for Fetal Development
• Prioritize protein-rich local options like tuna kilawin, paksiw na pata,
adobong mani, and taho with tokwa for protein needs
Omega-3 Fatty Acids
• Include fatty fish like tuna or bangus 2-3 times per week or consider
supplementing with fish oil after consulting a doctor

10. Safe Food Handling
• Practice proper food hygiene, especially with local street food.
• Wash hands thoroughly, ensure meat is cooked through, and avoid
unpasteurized dairy products.
Iron and Anemia Prevention
• Increase iron intake through local sources like iron-fortified rice, liver,
mongo beans, alugbati, and dark leafy greens.
• Consider iron supplements if recommended by your doctor.
Regular Prenatal Care
• Schedule regular prenatal visits with DOH-accredited midwives or doctors
as recommended.
• Utilize PhilHealth benefits for coverage.

11. Third Trimester (Weeks 28-40)
Blood Pressure Monitoring
• Monitor blood pressure regularly at home and during prenatal visits.
• Utilize free blood pressure checks at health centers.
Birth Plan and Labor Nutrition
• Develop a Birth Plan with your healthcare provider and discuss dietary
needs during labor and delivery.
• Prepare easy-to-digest snacks and fluids for labor.
Breastfeeding Preparation
• Attend breastfeeding education classes offered by DOH, local health
centers and nutrition offices.
• Consider lactation consultants in hospitals or community centers.

12. Implementing Rules and Regulations (IRR) of Republic Act
(RA) 11148 - “Kalusugan at Nutrisyong ng Mag-Nanay Act”
or First 1,000 Days Law of 2018
Rule 14: PARTICIPATION OF CSOs AND THE ACADEME
Section 1.
 Recognize the assistance from CSOs for the comprehensive and
effective implementation of the F1KD Strategy by the LGUs
including advocacy, monitoring and review
 Local Government Code shall serve as guide to LGUs in
encouraging participation of CSOs in the delivery of the services
under the program including raising awareness and information to
to the affected population
 Conduct regular Stakeholders’ meetings including advocacy
activities to encourage the participation and involvement of CSOs
CSOs in F1KD strategy implementation

13. Recommendations and Suggestions for NGOs to Improve
Nutrition during Pregnancy and Maternal Nutrition
I. Community Organizing and Mobilization
 Coordinate with LGUs to identify communities and populations to
be served, and other potential partners
 Assist in situational analysis including Family Profiling and
Community Spot Mapping
 Update masterlist of women of reproductive age
- Separate list of pregnant from lactating women
- Identify duration of pregnancy and status of lactating women
for targeting (Target Client List in RHU)
 Organize Mothers Clubs or Community Support Groups
- include male involvement

14. Recommendations and Suggestions for NGOs to Improve
Nutrition during Pregnancy and Maternal Nutrition
II. Coordination and Partnership
 Formalize the partnership with LGU support
- MOA or MOU with Terms of Reference
- Focal persons e.g., Barangay Captain, Kagawad on Health,
Barangay Nutrition Scholars or Barangay Health Workers
 Involve local health and nutrition service providers
- Ensure multi-sectoral collaboration and convergence
 Conduct consultative and coordination meetings
- Feedback, documentation and reporting
 Program planning and design
- Prioritize areas e.g., GIDA or target groups e.g., 4Ps
- Monitoring and Evaluation (activities, indicators)
- Implementation structure
- Resource mobilization

15. Recommendations and Suggestions for NGOs to Improve
Nutrition during Pregnancy and Maternal Nutrition
III. Provision of Services
 Assist or provide quality antenatal care including home visits
 Assist in monitoring of maternal nutrition status
- Body Mass Index /Mid-upper Arm Circumference (MUAC)
 Capacitate development of Birth and Emergency Plan
 Conduct Dietary Supplementation (Feeding Program)
- include incentives, parent / nutrition education sessions
 Deliver essential services
- Iron-Folic Acid or Multiple Micronutrient Supplement
- Other services e.g., deworming, laboratory, ultrasound
- Counseling (nutrition, breastfeeding, family planning)
- PhiHealth enrolment and Referrals
- Sustainability Plan

16. First 1,000 Days of Life
(F1KD)
Together let us maximize the
F1KD as the crucial Window
of Opportunity for Taller,
Healthier and Well-
developed Generations of
Filipino Children with a

17. EGLANTYNE JEBB
F O U N D E R
S AV E T H E C H I L D R E N
“ Every child deserves the best
humankind can give.”