BY KARMEL WONG

Special to The Herald-Sun

Before spending the year in India, I had thought of love and being loved as icing on the cake, a fluffy saccharine bonus — something people fret about missing only when they aren’t starving. But even amid scarce resources, in both India and here in Durham, a mother’s care makes a most substantial difference.

In the afternoon sun, Sharda-bhai sits on the courtyard floor, lifting her voice into high-pitched nonsense as she raises her baby into the air, then pulls him close to nuzzle her nose into his face. The child giggles and hides, gurgling delightedly. He nestles securely in her sari, his tummy peeking out from under a sleeveless white undershirt: the mark of nourishment.

To see a child here growing like this is not the norm. Sharda-bhai lives in Rajasthan, a state in north India known for rich Mughal history but also its harsh, dry climate that keeps food insecurity close at hand. Entering village homes, one finds a toddler so frail he could pass for a newborn; babies with loose canvas skin wrapped around limbs and arms; little brothers and sisters with wispy, grayish hair, ballooning bellies and feet puffy with fluid.

India itself houses one third of the world’s malnourished children — approximately 51 million of them. Statistically speaking, one in every two children under the age of 3 fails to reach normal weight. Those who survive may carry early deprivation forward, as disadvantage in the classroom, workforce, and later health. Far-reaching, these prospects have pushed for greater investment in child nutrition: providing free lunch meals in public preschool centers, exploring ways to harness locally made, ready-use therapeutic foods, encouraging mothers to breastfeed exclusively during their baby’s first months.

And yet we know calories alone are not enough. Sixty years ago, developmental psychologist Harry Harlow found that, given a choice, orphaned baby monkeys preferred to cling to surrogate mothers made of terrycloth, rather than wire-wrought ones that offered milk. Not only that, but monkeys fed and “raised” exclusively with these wire milk dispensers developed inadequately, compared to those who ate no more but grew up in the presence of fuzzy pseudo-mothers.

According to a 1999 World Health Organization report, children grow optimally when their early environment offers both adequate nutrients and attentive nurture — calories washed down with a glass of love. Moreover, there is evidence that even in households where calories fall short, warm, unfettered caregiving strengthens the bodies and minds of kids who might otherwise be stunted.

This kind of caregiving is not always easy. More than one in 10 mothers worldwide, for example, experience persistent and debilitating distress before and/or after childbirth. Even more still are simply trying to carry out their role in what feels like the most taxing of circumstances — their own hunger, too many responsibilities, too little support, heavy expectations — and they are tired.

What could help is support. Here in Durham, two out of five babies are born into impoverished families where financial and emotional stress all too easily drain away the mother’s natural capacity to care. But through the Durham Connects program, trained nurses have begun to knock on the doors of all new moms, connecting them with community resources so that they can better connect with their babies.

In South Asia, an emerging collaboration between researchers from India, Pakistan and London

is exploring how to equip existing community-based workers to deliver an innovative package of homebased postpartum support for rural mothers. The approach is to help babies survive, grow and develop healthily where there is every reason for them not to — not just by counseling a mother on best feeding practices, but also by partnering with her to solve parenting questions, manage stresses in her own life, and learn the dance of play and communication with her child. For when a mother feels more able,

when she is less overwhelmed, when she can enjoy how her little one smiles back at her, she heaps up the positive effects of the added attentiveness, for herself and the infant.

Because care matters, for children, for mothers, for life. As we celebrate Mother’s Day, here’s to Sharda-bhai, to mothers everywhere who, despite the odds, make the difference. May we — professionals, relatives, friends, neighbors — make a difference for them also.

After graduating from Duke University, Karmel Wong spent 10 months in Rajasthan, India, as a Hart Fellow with a child & maternal health NGO called ARTH (Action Research and Training for Health), conducting a community-based project on postpartum mental health in rural areas.