Importance of the First Thousand Days of Life
The concept of the first 1000 days of life, its importance for health, and actions to be implemented, especially by paediatricians for healthy nutrition and development were evaluated in a nonsystematic review published in the Jornal de Pediatria.
The concept of first 1000 days includes the period from conception to the end of the second year of life. This period offers a window of opportunity to improve maternal and child health and to provide highly effective interventions to reduce malnutrition. Six nutritional interventions with greater potential to save lives have been suggested by certain organisations and authors. These include iron and folic acid supplementation during pregnancy; breastfeeding; complementary feeding; vitamin A supplementation for children; use of zinc during diarrhoea; and ensuring sufficient water supply, sanitation, and hygiene practices for the families.
Exclusive breastfeeding is recommended for the first 6 months of age and should be continued up to 2 years of age. Complementary foods should be introduced in the child’s diet at 6 months of age, and breastfeeding should not be reduced upon the introduction of complementary foods. Children aged 6-59 months should be supplemented with vitamin A since its deficiency affects approximately 190 million preschool children. Iron and folic acid supplementation during pregnancy supports the intellectual development of the child and reduces the risk of death during childbirth. Diarrhoea and the probability of subsequent infections can be reduced by zinc supplementation. Diarrhoea and pneumonia can be effectively prevented by washing hands with soap. Additionally, the child should be provided with supportive and welcoming environment to develop strong attachments with their caregivers.
Paediatricians play a key role in educating parents and caregivers, implementing preventive and health-promoting interventions, and promoting actions emphasising the concept of the first 1000 days. Thus, focusing on actions during this crucial period may increase the chances of the child having a productive and healthy life, strong family ties, and also help in breaking the cycle of malnutrition.
News source - Cunha AJ, Leite ÁJ, Almeida IS. The pediatrician's role in the first thousand days of the child: the pursuit of healthy nutrition and development. J Pediatr (Rio J). 2015; 91(6 Suppl 1):S44-51.