Everyone knows it’s hard to get some kids to eat right. Now the American Academy of Pediatrics says kids’ brains depend on it. How you feed baby in the crucial “first thousand days” matters.
Karen Morse, a Ballard mom of two, has seen firsthand how some fussy toddlers refuse nutritious foods, even when they’ve been raised in a house where junk food is pretty much nonexistent and vegetables are homegrown.
“I did all the things that you read about in books that they tell you to do,” says Morse, laughing. She was not above hiding vegetables in pasta sauce. It didn’t work — at all. But her son did try berries. Once.
Better nutrition in utero and nutritious food in babyhood keeps low-income toddlers on pace cognitively and developmentally with their peers early in life and as the children grow up, according to the new advocacy policy statement, published in the AAP’s journal Pediatrics in 2018.
The key nutrition window is the “first thousand days,” beginning at conception and culminating at about age 2. The AAP calls for increased funding of programs that help ensure all families can feed their babies well during essential building years, and encourages exclusive breastfeeding for the first six months of life. While a much bigger issue abroad, undernourishment also happens in Seattle.
“There are families, certainly with the high cost of living that we have here … that are food-insecure,” says Dr. Lenna Liu, a University of Washington School of Medicine professor of pediatrics and pediatrician at Odessa Brown Children’s Clinic in the Central District. “They go hungry.”
The AAP’s cited inspiration was a study from rural Guatemala in the 1960s. Mothers and their children in two villages were given two different eating plans: one group received low-protein, low-calorie food supplements; the other, high-protein, high-calorie food supplements. The children from the first village scored lower overall on cognitive tests measuring facility with numbers, reading, and vocabulary and knowledge. The children from the better-supplemented village showed advantages well into their teen years.
The upshot? Plentiful, nutritious food during the first thousand days of life scan help build better brains and healthier children and adults. Sufficient levels of protein, calories and glucose during this period are crucial for early brain development, in addition to fatty acids, such as DHA, and vitamins and minerals.
That’s all achievable with access to nutritious foods, says Dr. Aisha Jimoh Reuler, a pediatrician at Polyclinic Northgate.
She says the study is not quite groundbreaking, but thinks it could have “significant impact” on how doctors guide patients.
“It’s very important for me to assess whether my patients and my families are experiencing any food insecurity,” said Reuler, noting that families will not always be upfront about problems that could affect getting food at home.
Pediatricians are asked to help food-insecure families get access to food and medical assistance, which can come from the federal WIC, SNAP or CHIP programs, as well as local food banks such as Northwest Harvest. One in five Washington children lives in a home where food isn’t easily obtained, according to Northwest Harvest. Finding good, healthy food, especially during those critical first thousand days, can also be particularly hard in Seattle-area food deserts, urban areas that are more than a mile from a supermarket, such as areas of South Seattle and south King County.
Meanwhile, parents struggling to feed nutrition-dense food to their young children often fight a tide of squeeze tubes and Goldfish crackers. If tots fill up on those, there’s less room for nourishing meals.
And, despite the new AAP position, Dr. Reuler notes that parents shouldn’t worry too much when a child isn’t choosing to eat a balanced diet. It’s making healthful food available that counts.
“Make sure that you’re offering all the nutrients you want them to have and know that over time, over weeks, they tend to get what they need.”
