Earlier this year, the American Academy of Pediatrics (AAP) issued a policy statement, Advocacy for Improving Nutrition in the First 1,000 Days to Support Childhood Development and Adult Health. “The most active period of neurologic development occurs in the first 1000 days of life, the period beginning at conception and ending at the start of the third postnatal year,” wrote Sarah Jane Schwarzenberg, M.D., and Michael K. Georgieff, M.D., members of the AAP’s Committee on Nutrition. Starting at conception and extending into the child’s second year, proper brain development depends on the mother and child taking in a healthy diet. While a person’s brain continues to develop throughout her lifetime, important processes that occur only within the first 1,000 days of life depend on proper nutrition. Drs. Schwarzenberg and Georgieff state
In the presence of a supportive environment, an attached primary caregiver, and a healthy diet, the brain typically thrives. In infants and children, toxic stress, emotional deprivation, and infection or inflammation have been shown to be associated with less optimal brain development, and a deficient diet for the child can worsen this. The effects of early adverse experiences may be a lifetime of medical and psychosocial problems, lost academic achievement and productivity, and possible effects on the next generation.
Given that food insecurity is a problem in the United States—12.9 million children lived in food-insecure households in the United States in 2016—the issue of proper nutrition for pregnant women and their infants and toddlers is a key issue to the pre-school community. A healthy diet, with brain-enriching nutrients, is a key way to improve a child’s ability to grow and learn; in contrast, even the best pre-k program’s effects can be undermined if the children show up and are unready to learn.
In an accompanying article, the AAP that pediatricians, family physicians, and other health care providers can take a number of steps to reduce the risk of malnutrition and its accompanying effects on children’s neurodevelopment. These include:
• Support breastfeeding. The AAP encourages doctors to support women to encourage breastfeeding, which provides nutrients, growth factors, and types of cells not found in formula that may play a role in brain development. The academy recommends exclusive breastfeeding until six months of age if possible, and continuing after solids are introduced for at least the first year.
• Advocate for nutrition support programs. The AAP urges pediatricians to advocate at the local, state and federal levels to strengthen nutrition programs with a focus on maternal, fetal and neonatal nutrition. Health care providers should know how to refer families to food pantries and other local resources.
• Promote healthy food choices rather than avoidance. Pediatricians and other child health care providers can recommend foods that supply the critical nutrients for brain development during particularly important times. This includes talking with families about which foods are “healthy” and rich in essential nutrients, and not just alternatives to junk food.