Cook Islands children (file image). Photo: Supplied/ UNICEF
A recent study in the Cook Islands has revealed a staggering 80 percent of children under 15 have poor oral health or are showing early signs of non-communicable diseases (NCDs).
Health officials in the Cook Islands are taking steps to improve the health of the nation's youngest citizens, turning their focus to the critical first 1000 days of a childs life.
The Cook Islands Ministry of Health has conducted a series of screenings over the past two years in schools across the country.
The nationwide screening, which included physical health, oral health, and rheumatic heart disease, uncovered troubling trends, especially regarding oral health.
Health Secretary Bob Williams said the need for urgent action is clear.
"Children in ECE (Early Childhood Education), grade one and two, there's 100 percent issues with their teeth, even for children in primary schools, we're looking at about 80 percent."
"Some of the children even at 15 years of age, are now pre-diabetic and there's some other health conditions as well."
Cook Islands children perform to welcome delegates at the opening ceremony of the 52nd Pacific Islands Leaders Meeting in Rarotonga. Photo: RNZ Pacific / Eleisha Foon
Another key concern is the prevalence of NCDs in the Cook Islands. Over half of the adult population (52 percent) is currently living with NCDs, a figure Williams said is deeply concerning.
Williams said the Ministry's action plan to address these figures involve focusing on nutrition in the first 1000 days of a child's life.
"We need to strengthen how we care for our babies since birth in the first 1000 days to ensure that babies get the best healthy meals that they need to grow to be a healthier baby and young child when they are growing up and going into the schools."
Williams said healthier babies equal healthier adults.
'Exclusive breastfeeding for six months'
A key component of their efforts is the 'Baby Friendly Hospital Initiative' (BFHI), which is a World Health Organisation UNICEF project to ensure breastfeeding is promoted, protected, and supported.
New Zealand midwife and lactation consultant Karen Palmer is in Rarotonga to help establish the initiative.
"BFHI was birthed in the 90s after several decades of high intervention rates with birthing and newborns, and many countries just about lost breastfeeding altogether," she said.
"Their infants were formula fed while the parents could afford it, and then when they couldn't afford it, these infants would perish from malnutrition."
Palmer said the world BFHI guidelines were created to stem that flow - improving maternity care and promoting breastfeeding.
She said breastfeeding is essential for laying down strong foundations for health, not only in infancy but throughout life.
"The goal really is exclusive breastfeeding for six months and then introduce food and keep going! Keep going as long as you like."
"Breastfed infants are less likely to be obese children and adults, less likely to get diabetes, less likely to have heart disease. Mothers who breastfeed all their children are much less likely to develop type two diabetes, heart disease and some cancers. So there are short- and long-term benefits to having most of the population breastfed for as long as possible."
Challenges to breastfeeding
However, challenges have made consistent breastfeeding difficult for some Cook Island families.
In the Cook Islands, maternity leave is only six weeks. Many mothers opt for expensive formula feeding when they have to return to work.
"The price of infant formula here is prohibitive when you consider the average wage and the cost of formula, that's about NZ$45 a tin, which is twice the price of what it is in New Zealand," she said.
"Sadly, families can't always afford that so they will then turn to something like Anchor milk powder, which might give the baby calories, but not the nutrients they need for brain growth and development."
In the past five months, however, Palmer said she has seen significant growth.
Community postnatal support services have been introduced, where a midwife visits new families in the first six weeks after birth to ensure they have the support they need.
The Health Ministry are beginning nutrition workshops with cooking classes to hone in on the importance of introducing healthy eating practices from a young age.
"The Mothers love it. We've already seen an increase in breastfeeding rates, and it has really strengthened postnatal care in the community. To have this initiative rolling well, is a big win."
Young Cook Islands warriors performed traditional pe'e chants to welcome guests to the 50th anniversary celebrations. (file image) Photo: Supplied / Airport Authority Cook Islands
Looking ahead
Despite the progress made, both Williams and Palmer agree that while the Cook Islands have made strides in improving maternal and child health, greater support and policy changes are necessary to sustain long-term improvements.
"We cannot do it by ourselves." Williams said, adding "that's why it's important that we work with our communities and work with the parents, and also work with government to introduce policy initiatives that will support the health and wellbeing of our children for their life course, while they are at school, and also for their life course after school"
The Ministry is working alongside Internal Affairs and government to implement policies aligning with their goals, ensuring healthier future generations of Cook Islanders.
As the Ministry prepares to officially launch the BFHI this month, Palmer and Williams are hopeful that these early interventions will bear fruit in the coming years.