A baby's nutritional environment during the first 1,000 days of life is critical to lifelong mental health and development, says an American Academy of Pediatrics (AAP) policy statement in the February 2018 Pediatrics. Guided by the new policy, the AAP sets a course to ensure pregnant women, infants, and toddlers get key nutrients necessary to build healthy brains.

"Advocacy for Improving Nutrition in the First 1,000 Days to Support Childhood Development and Adult Health," (published online Jan. 22), cites research revealing the rapid and complex sequences of brain growth that take place between conception and age 2. Adequate amounts of key minerals, vitamins, and macronutrients, such as protein and certain fats, during the prenatal period and the infant and toddler years, the report says, can help avoid permanent deficits in brain function. 

"The brain's structural foundation, along with billions of brain cells and trillions of connections between them, are built during this sensitive window of time," said Sarah Jane Schwarzenberg, MD, FAAP, lead author of the policy statement and an executive committee member of AAP's Committee on Nutrition. "Key nutrients provide the building blocks needed so that a child's brain can grow and develop normally," she said. 

The AAP calls on pediatricians to move beyond simply recommending a "good diet," to making sure pregnant women and young children have access to food that provides adequate amounts of brain-building nutrients.  These include protein, zinc, iron, choline, folate, iodine, long-chain polyunsaturated fatty acids, and vitamins A, D, B6, and B12. Among the steps recommended to help ensure access to these nutrients:

• 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 6 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.

"Research continues to show the critical role early nutrition plays in brain development," Dr. Schwarzenberg said. "One of the smartest ways we can boost children's chances for the healthiest and most productive lives possible is by making sure they get the foods they need."