"Advocacy for Improving Nutrition in the First 1000 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 said, 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 called 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.
The AAP policy statement clearly recognizes the critical role that nutrients play in brain development and long-term cognitive function, noted Tom Druke, director of VitaCholine brand development, Balchem Human Nutrition and Pharma. “Choline, iron, zinc and essential fatty acids are just a few of the key brain-building micronutrients noted by the AAP as being particularly important from conception through the second year of life,” he said.
Mr. Druke added that Balchem was particularly gratified to see choline included in the AAP statement as it builds upon the American Medical Association’s resolution last year, which advocated for prenatal vitamins to increase their choline content. “Choline is part of each and every cell membrane and children need it in vast quantities as they undergo rapid brain growth in the first 1,000 days. That’s why choline is typically found as an essential nutrient in infant formula and many of the leading brands use our VitaCholine products to meet that need.”
Researchers at leading universities have studied the essential role that choline plays in optimal brain development, Mr. Druke added. “More recent studies suggest that increased choline intake may improve infant cognition. Data from a Cornell clinical study recently published in The FASEB Journal provides compelling evidence that significantly higher choline intakes during pregnancy, particularly in the last trimester, may result in faster information processing for their babies.”
The steps AAP recommended to help ensure access to vital nutrients included:
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. Healthcare 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 healthcare 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."