Bridging Gaps in Infant Care: Lessons from the Field

Kiran conducting a community session on maternal health, nutrition, and hygiene with women and children in a rural household

I have been working with ZealGrit for over 14 months under Project First 1000 Days. During this time, I have worked closely with more than 200 pregnant and lactating mothers and their families. If there is one thing I have seen everywhere: families care no matter what. Just like any other family, people in Bihar also adjust their routines, their food, their sleep, their budgets for their child. And yet, I repeatedly meet children who are uncomfortable, frequently ill, or not gaining weight as expected. The challenge is incomplete information. My work is not about overloading families with instructions but filling in the missing gaps in a stage-wise, contextual and sensitive way.

Take exclusive breastfeeding for instance. With consistent follow-ups and conversations, most mothers I work with now practice exclusive breastfeeding for six months. That change happened because we kept returning to the “why” behind it. But once exclusive breastfeeding becomes consistent, another layer of care becomes visible. I often see that after feeding, the baby is laid down immediately. Within minutes, the child becomes restless and they often spit-up. Grandmothers usually say, “इसका पेट ठीक नहीं है” (her stomach is upset).

When we sit together and unpack what happened, we talk about how babies swallow air during feeding. That burping is not an extra step, but part of feeding itself. That holding the baby upright for a few minutes allows the trapped air to escape and prevents discomfort.

Around the six-month mark, another transition begins when complementary feeding has to be started. Most families usually think feeding should begin only when the child demands it. A few introduce tea and biscuits thinking they are harmless and easy to digest.

What is not fully visible to families is what is happening inside the child’s body at this stage.

After six months, nutritional needs increase rapidly, iron stores begin to decline, physical growth accelerates, brain development is active. If complementary feeding is delayed, too diluted or infrequent, the effects are gradual but serious, like weight gain slows, infections become frequent, and the child appears low on energy.

So instead of giving generic advice, we sit and connect feeding to growth, we cook together, discuss thickness and frequency, talk about responsive feeding and how to recognise hunger cues. Slowly, the uncertainty reduces.

A ZealGrit Foundation field session bringing together mothers and children to learn about nutrition, hygiene, and child health in a village

Then comes another common concern. Families say, “जबसे खिला रहे हैं, कभी कभी दस्त लग जाते हैं” (since we started feeding, the baby has started getting frequent diarrhoea). Sometimes it may be a digestion issue. But often, I observe feeding happens without handwashing because water is stored at a distance. At six to eight months, children begin crawling and they pick up whatever is around them and put it in their mouths. Germs enter easily causing loose motions and weight loss.

Here again, the challenge is how daily realities shape behaviour. So conversations expand around hygienic feeding practices, safe spaces for crawling and when loose motions require medical attention and why to continue feeding during illness instead of stopping.

Field work has taught me to be careful with assumptions. When a child is underweight, it is easy to conclude that the mother and family are not feeding enough or are being careless. But when I sit inside their home, I see the workload the mother carries. So instead of judging, I sit with them and help connect the full picture of daily practices, growth, hygiene and development, one message at a time.