The first 1,000 days: a window of opportunity for a brighter future for children

The first 1,000 days: a window of opportunity for a brighter future for children

image: Optimizing federal programs and policies can significantly improve nutritional outcomes in the 1,000-day window, a vital developmental period for children
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Credit: 1000 days

How can we help create a healthier and more equitable future for all pregnant women and their children? Infant and maternal mortality rates in the United States are among the highest of any wealthy country, with stark racial and ethnic disparities. There is significant scope to develop a unifying blueprint for appropriate policies and systems to improve the nutrition security and well-being of vulnerable families.

A new essay published in the American Journal of Public Health by Dr. Heather Hamner, health scientist at the Centers for Disease Control and Prevention, reveals many discrepancies between the dietary intake of pregnant women, infants and toddlers and the United States Department of Agriculture and Department of Health and Social Services. Dietary Guidelines for Americans, 20202025, with persistent racial and ethnic disparities across the spectrum. The average consumption of sugars, saturated fats and sodium is higher than the recommendations of the Dietary guidelines. The article also reveals that nearly 75% of infants are not exclusively breastfed during the first 6 months of life and 1 in 3 of them are introduced to complementary foods (other than breastmilk or formula). for infants) before the recommended age. Most children between 12 and 23 months do not consume the recommended amounts of vegetables, dairy products and fruits.

How do we go about filling these nutritional gaps? The test says “Advancing efforts related to research and surveillance, programs and communication, and dissemination could help positively and equitably influence the health and well-being of mothers and children.” It also describes a framework through which current federal policies and programs can be strengthened and how access to and uptake of programs can be improved.

Another article in the collection, written by Blythe Thomas, director of the 1,000 Days Initiative, an initiative of FHI Solutions, points out that a clear plan that unifies maternal and child nutrition policies and systems has escaped scrutiny. implemented in the United States. The document focuses on four areas where immediate actions can be taken and where long-term investments can have a significant impact on maternal and child health: early childhood development, health care, philanthropy and relations with the US government. “Achieving nutrition security in the first 1000 days will ultimately require multi-sectoral collaboration, advocacy and action to fully support families where they live, learn, work, play and gathersays Thomas, in his editorial.

A third article in the collection, authored by Dr. Kofi Essel, Community Pediatrician, Children’s’ National Hospital, discusses the limited focus on nutrition-related medical education as a significant constraint on pediatricians’ ability to provide nutrition. health and nutritional advice for the first 1,000 days. Using examples from the author’s own experience during her residency in pediatrics, the editorial explains that a paradigm shift on the importance of nutrition and nutritional counseling is important for improving clinical care. According to Dr. Essel, “This change requires a collective effort that inspires paediatricians to work in cross-sector collaborations to influence change alongside industry, researchers, and even early childhood educators. It compels pediatricians to use their voice to support local policy that changes the food landscape, supports national policy that improves nutrition security for our families, and transforms medical education for current and future providers.

These three articles are part of a special series, sponsored by 1,000 Days of FHI Solutions, which will appear in AJPH on October 26, 2022. The full series will present the state of science, research needs, and a policy agenda for a optimal maternal and child health. infant nutrition in the United States. Never before has a journal series collected articles on these topics during pregnancy, childbirth, the postpartum period, and infancy for the American population.

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Titles of original articles:

  1. Improving Nutrition in the First 1,000 Days in the United States: A Federal Perspective
  2. The first 1000 days: a missed opportunity for pediatricians
  3. From evidence to action: uniting around nutrition in the 1000-day window


  1. Heather C. Hamner, PhD, MS, MPH, Jennifer M. Nelson, MD, MPH, Andrea J. Sharma, PhD, MPH, Maria Elena D. Jefferds, PhD, Carrie Dooyema, MPH, MSN, RN, Rafael Flores-Ayala , DrPH, MApStat, Andrew A. Bremer, MD, PhD, Ashley J. Vargas, PhD, MPH, RDN, Kellie O. Casavale, PhD, RD, Janet M. de Jesus, MS, RD, Eve E. Stoody, PhD , Kelley S. Scanlon, PhD, RD, and Cria G. Perrine, PhD
  2. Kofi Essel, MD, MPH
  3. Blythe Thomas, BS

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