In the Journals

AAP: Nutrition in first 1,000 days key to proper brain development

Sarah Jane Schwarzenberg

Nutrition plays a crucial role in the neurodevelopment of children between conception and age 2; however, more assistance is needed for families regarding breast-feeding and dietary support, according to a policy statement issued by the AAP Committee on Nutrition.

“The downside [to not receiving proper nutrition within the first 1,000 days of life] is loss of cognitive or behavioral development as a result of failure of some neurologic pathways to develop normally,” Sarah Jane Schwarzenberg, MD, director of pediatric gastroenterology, hepatology and nutrition, and medical director of pediatric ambulatory services at University of Minnesota Masonic Children’s Hospital, told Infectious Diseases in Children. “Proper nutrition allows pathway development and gives the infant the optimal chance to meet his or her potential.”

Schwarzenberg and colleagues note that the areas of the brain and processes that develop within this time frame include the sensory systems, the hippocampus, myelination and the monoamine neurotransmitter systems. Additionally, rapid development is observed within this time for the prefrontal cortex, which is responsible for planning, attention, inhibition and multitasking. 

Proper nutrition between conception and age 2 is exceptionally important, according to the researchers, because lack of macronutrients early in life have been linked with lower IQ scores, diminished academic achievement and behavioral concerns.

Food insecurity is a concern in the United States. In 2015, 6.4 million households experienced a lack of adequate food caused by cost or lack of other resources. The researchers note that 36.8% of families with children who are born in impoverished households (below 185% of the poverty line) were food insecure at this time; however, unexpected life events, including divorce and unemployment, can put any household at risk for food insecurity.

Of the nutrients needed for healthy neurodevelopment, it is suggested that protein, fats such as long-chain polyunsaturated fatty acid, zinc, copper, iodine, iron, folate and choline are crucial for proper development in critical and sensitive periods of growth.

Schwarzenberg and colleagues have made the following recommendations to ensure proper nutrition from conception to 2 years:

  • Education on breast-feeding should be provided by pediatricians, family physicians, obstetricians and other child health care providers during pregnancy and should prepare to mediate problems that may occur;
  • Advocacy at local, state and federal levels is needed to support nutrition programs, with specific attention paid to maternal, fetal and neonatal nutrition;
  • Child health care providers should become knowledgeable about the nutrients needed for healthy neurodevelopment and what foods provide these nutrients;
  • Understanding which foods have positive nutrients and how they target development as positive factors to better suggest dietary changes;
  • A guide to healthy eating as a positive change, as opposed to avoidance of unhealthy foods, should be suggested by leaders to promote more prescriptive advice;
  • Emphasis on improving micro- and macronutrient options for infants and young children should be provided by existing programs, such as food pantries and soup kitchens, and supported by pediatricians and other child health care providers;
  • Pediatricians can urge families to enroll in early childhood nutrition programs, such as WIC, and assist in removing barriers to access; and
  • Potential neurodevelopmental concerns should be anticipated in children who have nutrient deficiency early in life.

“As the child turns 1, counseling families on providing a wide range of healthy foods, including fruits, vegetables and protein sources, is important,” Schwarzenberg said. “Helping families to avoid relying to so-called ‘super foods’ or less reliable nutrient sources is important as well.” – by Katherine Bortz

Disclosure: The authors report no relevant financial disclosures.

Sarah Jane Schwarzenberg

Nutrition plays a crucial role in the neurodevelopment of children between conception and age 2; however, more assistance is needed for families regarding breast-feeding and dietary support, according to a policy statement issued by the AAP Committee on Nutrition.

“The downside [to not receiving proper nutrition within the first 1,000 days of life] is loss of cognitive or behavioral development as a result of failure of some neurologic pathways to develop normally,” Sarah Jane Schwarzenberg, MD, director of pediatric gastroenterology, hepatology and nutrition, and medical director of pediatric ambulatory services at University of Minnesota Masonic Children’s Hospital, told Infectious Diseases in Children. “Proper nutrition allows pathway development and gives the infant the optimal chance to meet his or her potential.”

Schwarzenberg and colleagues note that the areas of the brain and processes that develop within this time frame include the sensory systems, the hippocampus, myelination and the monoamine neurotransmitter systems. Additionally, rapid development is observed within this time for the prefrontal cortex, which is responsible for planning, attention, inhibition and multitasking. 

Proper nutrition between conception and age 2 is exceptionally important, according to the researchers, because lack of macronutrients early in life have been linked with lower IQ scores, diminished academic achievement and behavioral concerns.

Food insecurity is a concern in the United States. In 2015, 6.4 million households experienced a lack of adequate food caused by cost or lack of other resources. The researchers note that 36.8% of families with children who are born in impoverished households (below 185% of the poverty line) were food insecure at this time; however, unexpected life events, including divorce and unemployment, can put any household at risk for food insecurity.

Of the nutrients needed for healthy neurodevelopment, it is suggested that protein, fats such as long-chain polyunsaturated fatty acid, zinc, copper, iodine, iron, folate and choline are crucial for proper development in critical and sensitive periods of growth.

Schwarzenberg and colleagues have made the following recommendations to ensure proper nutrition from conception to 2 years:

  • Education on breast-feeding should be provided by pediatricians, family physicians, obstetricians and other child health care providers during pregnancy and should prepare to mediate problems that may occur;
  • Advocacy at local, state and federal levels is needed to support nutrition programs, with specific attention paid to maternal, fetal and neonatal nutrition;
  • Child health care providers should become knowledgeable about the nutrients needed for healthy neurodevelopment and what foods provide these nutrients;
  • Understanding which foods have positive nutrients and how they target development as positive factors to better suggest dietary changes;
  • A guide to healthy eating as a positive change, as opposed to avoidance of unhealthy foods, should be suggested by leaders to promote more prescriptive advice;
  • Emphasis on improving micro- and macronutrient options for infants and young children should be provided by existing programs, such as food pantries and soup kitchens, and supported by pediatricians and other child health care providers;
  • Pediatricians can urge families to enroll in early childhood nutrition programs, such as WIC, and assist in removing barriers to access; and
  • Potential neurodevelopmental concerns should be anticipated in children who have nutrient deficiency early in life.

“As the child turns 1, counseling families on providing a wide range of healthy foods, including fruits, vegetables and protein sources, is important,” Schwarzenberg said. “Helping families to avoid relying to so-called ‘super foods’ or less reliable nutrient sources is important as well.” – by Katherine Bortz

Disclosure: The authors report no relevant financial disclosures.