Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health

Sarah Jane Schwarzenberg, MD, FAAP, Michael K. Georgieff, MD, FAAP, COMMITTEE ON NUTRITION

Schwarzenberg Jane S, Georgieff K. M et al, 1 February 2018, Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health, Pediatrics (February 2018), 141(2)


Maternal prenatal nutrition and the child's nutrition in the first 2 years of life (1000 days) are crucial factors in a child’s neurodevelopment and lifelong mental health. Child and adult health risks, including obesity, hypertension, and diabetes, may be programmed by nutritional status during this period. Calories are essential for growth of both fetus and child but are not sufficient for normal brain development. Although all nutrients are necessary for brain growth, key nutrients that support neurodevelopment include protein; zinc; iron; choline; folate; iodine; vitamins A, D, B6, and B12; and long-chain polyunsaturated fatty acids. Failure to provide key nutrients during this critical period of brain development may result in lifelong deficits in brain function despite subsequent nutrient repletion. Understanding the complex interplay of micro- and macronutrients and neurodevelopment is key to moving beyond simply recommending a “good diet” to optimizing nutrient delivery for the developing child. Leaders in pediatric health and policy makers must be aware of this research given its implications for public policy at the federal and state level. Pediatricians should refer to existing services for nutrition support for pregnant and breastfeeding women, infants, and toddlers. Finally, all providers caring for children can advocate for healthy diets for mothers, infants, and young children in the first 1000 days. Prioritizing public policies that ensure the provision of adequate nutrients and healthy eating during this crucial time would ensure that all children have an early foundation for optimal neurodevelopment, a key factor in long-term health.

AAP — American Academy of Pediatrics
CACFP — Child and Adult Care Food Program
DGA — Dietary Guidelines for Americans
SNAP — Supplemental Nutrition Assistance Program
USDA — US Department of Agriculture
WIC — Special Supplemental Nutrition Program for Women, Infants, and Children


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