The Complete Science of Early Years’ Nutrition | Dr Ajay Prakash | The Parent Lab x Nestlé FamilyNes

This content is not a substitute for professional medical advice. Please consult your healthcare professional.

Disclaimer: Mothers are informed that breast milk, especially the yellowish colostrum secreted in the first week after delivery, is highly nutritious and contains more protein, anti-infective properties, and Vitamin A. Breast milk is a complete food for the first six months, protects against infections, is always available, and requires no preparation. It is also more economical than infant milk substitutes.

Breastfeeding immediately after delivery helps the womb contract and supports the mother in regaining her figure quickly. Frequent suckling and maternal confidence are key to success. Mothers should be encouraged and supported, with proper care of breasts during pregnancy. Infants should be breastfed as soon as possible after birth, and mother and child should stay together (rooming-in). Colostrum must be given and not discarded in favor of sugar water or other substitutes. Infants should be fed on demand, and hygiene for both mother and child must be maintained.

Introduction & The "First 1,000 Days"

Kriti Vij (Host): No, this is one of the most common things we hear. But here's the catch: a child can eat plenty and still miss the nutrients that matter most in their growth. Because in the first 1,000 days, food is not just filling the tummy—it's wiring the brain, building the body, and shaping behavior. But what exactly is the first 1,000 days? What does it actually mean for parents? Why is this window considered so critical that it cannot be made up later?

Let's talk to Dr. Ajay Prakash, a pediatrician and neonatologist from Tamil Nadu. Welcome, Doctor!

Dr. Ajay Prakash: Thank you.

Kriti Vij (Host): So Doctor, you mentioned that the first thousand days in a child's life are very, very important. Now, we are not thinking about food from pregnancy onwards because this phase is pregnancy to the second birthday. We think of food in the "now." So can you tell us why this thousand-day period is so critical and so important?

Dr. Ajay Prakash: Actually, these thousand days are called the critical period in nutrition. So, from the day of conception till two years of age—from what the mother is eating till the child is two years of age—is very crucial.

During pregnancy, everyone will say the mother has to eat more. It's actually more about the quality, not the quantity. For example, the mother should have micronutrient-dense food—folic acid, vitamin D, calcium. So the diet should be nutrient-rich, not just about quantity.

Kriti Vij (Host): Right. So these thousand days from pregnancy to two years... the child's eating patterns and what they're consuming is changing quite a bit through this entire phase. Can you tell us a little bit about that?

Dr. Ajay Prakash: From the time of delivery till six months, the gold standard is mother's milk. From six months of age, the nutrient demands actually increase, which cannot be fulfilled by mother's milk alone. That's where the home food comes in. So that also should be nutrient-dense. As I mentioned for the mother, the baby's food should be rich in iron, folic acid, and vitamins.

### Brain Growth & Nutritional Gaps

Kriti Vij (Host): Right. And what if this window has a few gaps? Say, for example, maybe a mother wasn't giving exactly or wasn't being provided a very nutrient-rich or dense diet during pregnancy. Does that really affect the thousand days, or do you think that those gaps can be filled? 

Dr. Ajay Prakash: Yeah, the gaps can be actually filled, but we cannot completely replicate the process if we have missed the most important things like brain growth. As you mentioned, these critical days are responsible for brain growth. 70% of the brain growth is completed before the child turns two. So we cannot completely replicate, but we can compensate.

Kriti Vij (Host): Okay. I think this is a very important thing for parents to hear because the first thousand days, like you're saying, set the foundation for the road ahead for a child's growth.

Dr. Ajay Prakash: Exactly.


 

### Pregnancy Nutrition: Myths vs. Science (The "Big Five")

Kriti Vij (Host): So Doctor, when I was pregnant, I heard a bunch. I heard "eat for two," "avoid papaya," "drink milk every night." Now I want to know, how much of this is science and how much of this is myth?

Dr. Ajay Prakash: Actually, this is a very interesting question. Most of the advice circulating in families like "eat this, eat that, avoid this, avoid that" is almost cultural, not clinical. Let me put it in this way: the exact extra calories needed for a pregnant woman, that too in the second and third trimester, is just 300 to 500 kilocalories, which is actually just one more balanced meal, not double the size or double the portion.

Kriti Vij (Host): Right, so what you're basically saying is this "eat for two" is a myth, but to eat nutrient-rich food, I guess, is what one has to look at. 

Dr. Ajay Prakash: To be medically precise, there are the "Big Five" micronutrients in pregnancy:
1. Folic Acid: Which everyone knows. All mothers take folic acid tablets during the first trimester, which is responsible for the baby's brain development as well as to prevent neural tube defects in the brain.
2. Iron: Which is again responsible for the baby's blood production and the oxygenation of blood in the brain.
3. Vitamin D and Calcium: Which are responsible for the baby's bone development.
4. Iodine: Which is responsible for the thyroid function.
5. Omega-3 Fatty Acids and DHA: Which are found in fish and ghee, and are responsible for the baby's brain and eye development. 

So what matters most is the micronutrient density in the mother's diet, not the portions. That is what needs to be looked at during the pregnancy trimesters.


### Early Feeding: Breast Milk vs. Formula & Gut Health

Kriti Vij (Host): Interesting. So Doctor, let's talk about the baby's first food, which is milk. Now, whether it is breastfeeding or formula-based, I want to understand: there are so many opinions that circulate, right? Like "add honey," "give water," "drop night feeds." How much of this is science, and where should a parent stand with these kinds of opinions?

Dr. Ajay Prakash: For the first six months, breast milk is the gold standard. If breast milk is not available, the next safer substitute is formula.

One of the most interesting facts about breast milk is that it is a living fluid. It changes its composition every day depending on the baby's needs and the baby's age. Breast milk contains 90% water, whereas formula is mixed with water. So there is no need for additional water, which has zero nutrients and is absolutely going to fill the baby's tummy, leaving no place for actual food. This is for 0 to 6 months.

And coming to gripe water, we all know it contains sodium bicarbonate, which actually alters the baby's gut pH. Overall, it collapses the gut-brain axis. And the third thing, honey, contains a bacterium called *Clostridium*, which affects the baby's gut. Till one year of age, the baby cannot digest this bacterium, whereas after one year, our gut is ready to remove the toxins from the gut. So these three are totally unnecessary. Moreover, the baby's kidney and gut are very immature to handle all these other things apart from milk.

Kriti Vij (Host): I'm sure a lot of parents would really appreciate hearing this at whatever stage they're in at this point.


### Human Milk Oligosaccharides (HMOs)

Kriti Vij (Host): Interesting. So Doctor, we hear this term HMOs. What does this mean?

Dr. Ajay Prakash: The most fascinating part of HMOs (Human Milk Oligosaccharides) is they are not going to feed the baby directly. They pass through the gut undigested and feed the good bacteria in the baby's gut. This is responsible for improving the baby's gut immunity and making sure the baby's gut can identify good bacteria or bad bacteria, and it reduces inflammation. Most importantly, two serious infections—necrotising enterocolitis and respiratory infections—can be prevented by these HMOs. There are actually 200 HMOs in breast milk, which is why we say it is irreplaceable.


### Protein Content: Mother's Milk vs. Cow's Milk

Kriti Vij (Host): So Doctor, another thing that parents worry about is protein: high protein, low protein, whey protein... it's all a little bit confusing. Can you break that down for us?

Dr. Ajay Prakash:  
Mother's milk contains the right amount of protein for the baby's gut. But still, people are confused and think they need extra protein, opting for cow's milk even in 2026, even in urban settings. This is actually not good and worsens the baby's gut. Cow's milk contains higher protein, but it is not suitable for the baby's gut.

Mother's milk contains less protein, which is like 0.9 g per 100 ml, but it is exactly what the baby needs. And the whey-to-casein ratio, as you mentioned, is 70 to 30%, which is suitable for the baby's gut and is responsible for the proper amino acid profile required to build muscle and brain development—not the protein from cow's milk.


### The Truth About Night Feeds

Kriti Vij (Host): So Doctor, what about night feeds? Should they be stopped? Because sometimes you'll hear people say that you should stop them so the child knows how to manage their hunger, and you know, it'll regulate sleep better, things like that. Because I've had too many sleepless nights doing a lot of night feeding because my baby would wake up and require a night feed. Is that something that can happen or should happen? What is the science around that? 

Dr. Ajay Prakash: Yes, actually, night feeding is not a habit to break. It is a physiological need of the baby. The baby's gut is very small and has a very small capacity, so the baby's hunger keeps on coming even in the night. We cannot stop it as such. In the early few months of life, the baby needs nighttime feeds as well. We should not follow the clock; we should follow the hunger cues of the baby.

Kriti Vij (Host): Yeah, your baby will tell you what you need to do.

Dr. Ajay Prakash: Exactly.


### Complementary Feeding at 6 Months & Hidden Deficiencies

Kriti Vij (Host): You know, the first six months bring so much excitement, of course, but a lot of confusion. Now, when the child is going to start eating their first foods—and sometimes families will have traditions like a biscuit or something, or honey, or whatever—what should those first foods be? And if, for example, those first foods go wrong, can we fill the gaps later?

Dr. Ajay Prakash: There are two things actually happening after six months. First, the natural iron stores in the baby start depleting. Second, the iron content from milk is not enough to meet the baby's demands. So we have to start proper, iron-rich complementary feeding—not as a replacement for milk, but as a top-up feed apart from the mother's milk.

Coming to other things like biscuits and cow's milk again: all this tradition comes up in every family. They always ask the same question in my OPD: "When should I start the biscuit so that the baby gains weight?" It's true that if the baby starts eating biscuits and cow's milk, they will gain weight. They look healthy, but there will be a hidden nutritional deficiency. Ideally, these are not good foods to start with. 

Kriti Vij (Host): So what are the good foods to start with?

Dr. Ajay Prakash: That's a good question. As I mentioned, iron-rich food. We should start with purees, like carrot, beet, pumpkin, spinach purees, and mashed dal. Apart from that, you can opt for fortified cereals as well.


### The Harmful Myth of Cow's Milk Before 1 Year

Kriti Vij (Host):  Okay. Doctor, another big debate question: Is cow's milk healthier than any other food that we make at home, like homemade food?

Dr. Ajay Prakash: It is genuinely a harmful myth. Every parent thinks the same way: "The baby doesn't eat anything, so go for a cup of milk." Actually, till 12 months of age, cow's milk is harmful to the baby. It irritates the gut lining and causes micro-bleeding, so the baby loses iron. Naturally, iron deficiency sets in.

Secondly, it has higher protein and minerals, which is an overload to the baby's small kidneys. It will affect the kidney. It also does not contain essential fatty acids and vitamins which are naturally available in breast milk as well as in homemade food. So it's a big myth. I suggest starting cow's milk only after one year of age, and that too as a beverage, not as a replacement for food. It should be like once or twice a day.

### Iron & Zinc Deficiencies in Toddlers

Kriti Vij (Host):  Right. Doctor, by toddlerhood, a dinner table usually looks like a war zone because parents are panicking about weight and grandparents are saying, "Oh, I love the chubby cheeks." I want to ask you this: genuinely, a healthy-looking child can still be iron-deficient, right? Why is iron deficiency such a topic of concern? 

Dr. Ajay Prakash: As you said, not all healthy-looking babies are actually healthy. There can be nutritional deficiencies, particularly iron. As Indians, we know our household foods are always like rice, wheat, and milk, which are all poor sources of iron. But they actually make the baby chubby and healthy-looking. That's why we mostly miss iron deficiencies.

We also miss the actual symptoms. For example, the baby might often get cold, cough, or fever; their focus and concentration on studies might decrease; or their sleep pattern might alter. We commonly mistake this as a normal part of development because our child's weight and height are good. Actually, these are all the early signs of iron deficiency. We usually only worry when we see the reports and the hemoglobin is down. Till that time, we think the baby is healthy because of good weight and height, but that doesn't tell the whole story.

Kriti Vij (Host): Okay. Other than iron deficiency, what other nutrients should one actually look for? I know iron is an important one, but are there any others that we should focus on?

Dr. Ajay Prakash: As far as our Indian kids are concerned, iron and zinc deficiency is very common. 

Kriti Vij (Host): And what other deficiencies do you notice in your practice?

Dr. Ajay Prakash: Coming to macronutrients, we are worried only about the amount of rice or the number of chapatis the kid eats, not about the protein intake. In our Indian households, for breakfast, we usually go for idli, dosa, or chapati. There is no proper balanced meal. Only lunch contains an adequate amount of carbs, protein, and fat. So, as far as macronutrients are concerned, protein deficiency is very common. The children are chubby, but they are not muscular, which is very important. Muscle is built from adequate protein, which is missing in many households.

Coming back to micronutrients, apart from iron, there is a deficiency of zinc, which we usually miss and don't care about. Zinc is actually very good for the gut and respiration. It improves the local immunity in the respiratory tract and in the gastrointestinal (GI) tract, preventing recurrent respiratory infections or recurrent diarrhea.


### How Long to Breastfeed?

Kriti Vij (Host): Okay. Some mothers continue to breastfeed even after a year, and some others will switch to different alternatives. Is there any right answer? 

Dr. Ajay Prakash: There is no right answer to this question. Till one year, we can give mother's milk, but the World Health Organization (WHO) recommends continuing till two years of age. What I personally recommend is that till one year is fine, because after one year, what happens in most households is the baby starts drinking more breast milk. If the baby is hungry, the baby will search for the mother, not for food.

If the baby is willing to take the right amount of food and is taking breast milk as a beverage twice or thrice a day, that is fine. But if the baby is completely depending on the mother's feed and always searching for the mother when hungry, then it is not fine. Obviously, the final answer should be given by the mother; it completely depends on her. What I personally believe is:
* 0 to 6 months: Exclusive breastfeeding.
* 6 months to 1 year: Breastfeeding plus a proper complementary diet.
* After 1 year: Depends on the baby and mother.


### Understanding the Gut Microbiome and the "Second Brain"

Kriti Vij (Host): Right. Doctor, a lot of new parents on Parent Talk/Parent Tune are asking the big question about the microbiome. What is this? What are prebiotics, probiotics, and gut health? We have zero information about this, so please decode this a little bit for me.

Dr. Ajay Prakash: Yes. Actually, the microbiome is the balance of good and bad bacteria in the baby's gut, which is actually decided *in utero*. There are multiple factors affecting this microbiome, starting with vaginal birth (which a baby does not get from a C-section), followed by mother's milk, which contains good probiotics and prebiotics. From six months onwards, the amount of proper, good food the baby takes also affects it.

And coming to the treatment part, parents these days want more antibiotics to make the baby recover faster, which is actually not good. In the rural area where I practice, people want the baby to recover as early as possible. They want the fever to go the next day. If I don't prescribe antibiotics, they will choose another doctor. So, inappropriate use of antibiotics is a major factor. All these factors affect the microbiome.

The microbiome is actually directly connected to the brain. What we call the gut these days is the "second brain." It has more nerves than the spinal cord, and it connects directly to the brain through a nerve called the vagus nerve, which is responsible for everything.

That's why everyone is worried about this gut-brain axis. Whatever you are putting in the gut is going to be responsible for how the child's future is going to be—including cognition, writing, and intelligence. Everything depends on what you put inside.

Kriti Vij (Host): So the antibiotics you mentioned can really affect the gut health of a child.

Dr. Ajay Prakash: Exactly. Because antibiotics don't know what is a good bacterium and what is a bad bacterium; they just kill all bacteria. But our gut needs good bacteria for digestion and the absorption of nutrients to happen.

 

### Baby-Led Weaning (BLW) vs. Traditional Spoon Feeding

Kriti Vij (Host): Got it. Doctor, what is baby-led weaning, is it safe, and how do you compare it to spoon feeding? What is your opinion on it?

Dr. Ajay Prakash: Baby-led weaning (BLW) is actually putting the baby in a separate high chair and making them eat on their own instead of spoon feeding. This is quite common in Western countries, but it is getting popular in India these days as well.

What I personally suggest is a combination of both. I would not suggest BLW alone, nor would I suggest traditional feeding alone. A combination is ideal because there is a risk of choking with BLW, whereas in traditional spoon-feeding, the baby never tries to eat on their own. Both have pros and cons.

That's why I suggest a combination:
* At 6 months: Start with purees, feeding them with a spoon.
* At 7 to 8 months: Mashed food, also fed with a spoon.
* At 9 to 10 months: When the baby can sit up completely, take food, and eat on their own, they develop a grasp. During that time, you can go for baby-led weaning. At this stage, the baby knows how to bite and chew, so the choking hazard is also less. 

My personal suggestion is that the feeding style can be anything, but the most important thing is that the baby should get proper nutrients and nutrient-dense, iron-rich food.


### Five Nutrition Truths for Every Parent

Kriti Vij (Host): Let us end with five truths that every parent should know.

Dr. Ajay Prakash:  
1. Number One: Early nutrition isn't just food; it's the foundation.
2. Number Two: Milk matters, but timing matters too.
3. Number Three: Iron is the hero of the second half of the first year.
4. Number Four: Texture plus flavor equals confidence.
5. Number Five: There is no perfect way—only the informed way. [19]

Kriti Vij (Host): Thank you so much, Doctor. You have really opened my eyes. I've learned a lot in this short conversation. Thank you so much.

Dr. Ajay Prakash: Thank you so much. Remember, you're not just feeding a tummy—you're shaping a lifelong relationship with food. Stay curious, stay patient, and enjoy the journey.

Kriti Vij (Host): Until next time, this is the Parent Lab on Parent Tune, where every question finds its science. Thanks!