The pediatrician's role in the first thousand days of the child: the pursuit of healthy nutrition and development

J Pediatr (Rio J). 2015 Nov-Dec;91(6 Suppl 1):S44-51. doi: 10.1016/j.jped.2015.07.002. Epub 2015 Sep 6.


Objectives: To describe the concept of the first 1000 days, its importance for health, and actions to be implemented, particularly by pediatricians, in order to attain healthy nutrition and development.

Sources: A nonsystematic review was carried out in the SciELO, LILACS, MEDLINE, Scopus, and Web of Science databases, encompassing the last decade, using the terms 1000 days, child nutrition, child development, childhood, and child. A non-systematic search was performed online for organizations that use the 1000-day concept and give recommendations on children's health.

Summary of the findings: The first 1000 days range from conception to the end of the second year of life. It represents an important period to implement interventions to ensure healthy nutrition and development, which will bring benefits throughout life. Children should receive adequate nutrition, through proper prenatal diet, exclusive breastfeeding for the first 6 months, addition of adequate complementary foods, and continued breastfeeding up to 2 years of life. Given the condition of absolute dependence on an adult's care, it is crucial to establish an enabling and friendly environment, necessary for the development of strong bonds with caregivers, laying the groundwork for a full and healthy development.

Conclusions: The pediatrician, together with other professionals, can act by promoting actions emphasizing the concept of the first 1000 days to ensure healthy nutrition and development. Focusing on actions in this period may increase the child's chance of having a healthy and productive life in the future, strengthening family and community ties, helping to break the intergenerational cycle of poverty.

Keywords: Child development; Child health; Child nutrition; Desenvolvimento infantil; Maternal–child health; Nutrição infantil; Saúde da criança; Saúde materno-infantil.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Child Development / physiology*
  • Child Nutritional Physiological Phenomena / physiology*
  • Child, Preschool
  • Health Promotion*
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena / physiology
  • Nutrition Policy
  • Nutritional Status
  • Pediatrics*
  • Physician's Role*
  • Socioeconomic Factors