A recent study identified 5.9 million ‘zero food’ children in India, who are infants aged 6 to 23 months and have not consumed significant calories in 24 hours. Two out of 10 infants in this age group had no solid or liquid food for a day. The percentage of zero food children increased from 17.2% in 2016 to 17.8% in 2021.

In this context, maternal nutrition seems important for the following reasons:

• Scientific evidence shows that the first 1000 days are key for proper nutritional development of every infant and mother.
• Women’s health and nutrition status, including weight, haemoglobin levels, age at conception, and micronutrient levels during periconceptional period, are crucial determinants for the child’s health.
  • Maternal undernutrition is estimated to cause 20% of childhood stunting in India, and 20-30% of infants experience under nutrition even during exclusive breastfeeding phase (first 6 months).
• Breastfeeding counselling during antenatal check-ups and frequent home visits have a significant impact with evidence indicating that infant daily weight gain increased by 30-35 grams, and underweight prevalence reduced by almost two-thirds.
• As per NFHS-5 survey, over 57% of women (15-49 years) suffer from anaemia, which has major consequences. India loses up to 1.18% of GDP annually due to iron deficiency.

Since under-nutrition and stunting that occurs in the first 24 months of life is largely irreversible, and contributes to an intergenerational cycle of poor growth and development, maternal nutrition needs to be made a priority in the following ways:

• Increased financial commitment: Mission Saksham Anganwadi and POSHAN 2.0 programme have seen only a marginal increase in budgetary allocation in 2022-23. Additionally, 32% of funds released under POSHAN Abhiyaan have not been utilised.
• Empowering frontline health workers (FHWs): FHWs are driving nutritional outcomes at the last mile. Thus, focus on their regular skilling, supportive supervision and motivation to deliver services would strengthen the nutrition system.
• Focus on girl child and adolescents: Adolescence is a crucial time to promote dietary diversity and correct nutritional deficiencies, particularly for girls, since their better health improves outcomes in future generations also.
  • Considering the 5% rise in anaemia among adolescent girls in NFHS-5 compared to NFHS-4, there is a need to adopt a gendered perspective in the National Nutrition Mission.
• Awareness creation: Awareness campaigns could involve discourses on care in the first 1000 days to educate mothers as awareness has a strong correlation with reducing gender-bias and improving girl-child health and nutrition.
  • This needs to be supplemented by strengthened nutrition counselling for adolescent girls, building a strong ecosystem in schools to promote healthy diets, and conducting community-based educational events.
• Addressing hidden hunger: Currently, 80% of adolescents suffer from micronutrient deficiencies, especially girls. Thus, addressing deficiencies of not just iron and folic acid, but also vitamin B12, vitamin D, and zinc is required.

Moreover, social movements for women’s rights and care during adolescence and pregnancy need a strong thrust for addressing the issue of preconception nutrition, maternal nutrition, and appropriate infant and child feeding to fulfil the dream of a ‘Kuposhan-Mukt Bharat’.