Under a large tent outside a medical clinic in El Quinche, Ecuador, shiny pink streamers sway in the April breeze. It seems like an unlikely place for a baby shower, but the women gathered here are familiar with the spot. They first entered the tent months before as newly expectant mothers, referred by their health-care providers to register for the Mikhuna Project, a WashU-led study on maternal nutrition and infant brain formation.
The participants returned to the tent throughout their pregnancies to pick up food, learn about nutrition and receive medical exams. On this day, they gather to celebrate some of the babies soon to arrive — infants whose brain scans may help countless more children in the future.
Here in Ecuador, 25% of young children experience stunted growth, usually due to malnutrition. Among the country’s Indigenous children, the number jumps to 40%. Globally, nearly 150 million children are stunted. Participants in the Mikhuna Project and their babies are contributing valuable data that may help reduce these troubling statistics.
Lora Iannotti, PhD, founder and director of the E3 Nutrition Lab and a professor at WashU’s Brown School, has been combatting childhood malnutrition and stunted growth for decades. Her research projects in Haiti, Ecuador, Kenya and Madagascar have focused primarily on a child’s critical first 1,000 days of life.
“The consequences of being undernourished in that period can be irreparable,” Iannotti says. “If nutrition is compromised by poor-quality diet, infectious disease or otherwise during the first 1,000 days of life, children will likely never reach their full genetic potential.”
Stunting is defined by a child’s height-for-age relative to growth standards set by the World Health Organization (WHO), but the effects go far beyond physical stature. Stunted growth can lead to issues with cognition and school performance. It’s associated with lower productivity and wages later in life and may even result in intergenerational impacts.
With funding from the Children’s Discovery Institute, a partnership between St. Louis Children’s Hospital and WashU Medicine, Iannotti and collaborators at the Universidad San Francisco de Quito (USFQ) in Ecuador are testing the effects of an intervention that aims to reset the starting clock. The researchers want to see how tackling malnutrition before a child is born, starting with a pregnant woman’s diet, shapes growth. And rather than relying on proxy measures like height, they seek to directly understand how maternal diet affects infant brains.
“What’s exciting about Mikhuna is that it introduces measures of the brain that are often hard to capture at the community level,” Iannotti says. “It’s a fascinating and understudied area.”