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Try out PMC Labs and tell us what you think. Learn More. Optimized nutrition during the first days from conception through the 2nd birthday is critical for healthy development and a healthy life for the newborn. Pregnancy and the postpartum period are accompanied by physiological changes, increased energy needs, and changing requirements in the nutrients critical for optimal growth and development. Infants and toddlers also experience physiological changes and have specific nutritional needs.

Food and nutrition experts can provide women of childbearing age with adequate dietary advice to optimize nutrition, as well as guidance on selecting appropriate dietary supplements. Considering the approaching — Dietary Guidelines for Americans DGA will be making specific recommendations for children, it is important to provide accurate scientific information to support health influencers in the field of nutrition.

The purpose of this review is to summarize the nutrition and supplementation literature for the first days; to highlight nutritional and knowledge gaps; and to educate nutrition influencers to provide thoughtful guidance to mothers and families. Optimal nutrition during pregnancy through early childhood is critical for supporting a healthy life. Optimal nutrition during this time is essential for supporting critical periods of fetal growth and development, maternal health including the postpartum period and lactationand for fueling infant and toddler growth until two years of age.

Failure to provide key nutrients during the first days of life can result in developmental shortfalls such as a lifelong deficit in brain function. To help optimize development and to fuel a healthy pregnancy, all essential nutrients should be included in the diet. Other nutrients, including B vitamins, magnesium, vitamin A and other trace minerals, are discussed, as they relate to topics such as maternal, infant and toddler nutrient deficiency and supplementation.

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The upcoming — Dietary Guidelines for Americans DGA will make specific recommendations for children, and it is important to provide accurate scientific information to support health influencers, such as dietitians and other health professionals, in the field of nutrition. Therefore, the purpose of this review is to 1 summarize the available scientific evidence regarding physiological and nutritional requirements during the first days of early life; 2 describe scientific data on the benefits of dietary nutrition supplements; and 3 provide professionals with a nutritional guidance document on pregnancy through early childhood.

A narrative literature review was conducted in February of with a team of nutrition research scientists Figure 1. An initial, comprehensive search for all research was conducted in PubMed, Scopus, and Cochrane databases to understand the current research available surrounding intake, deficiency and supplements of key nutrients during the first days life period. Due to the large scope of topics covered in this review, a supplement has been included to provide an example of the search terms used Figure S1.

The search strategy did not place any limits on date, however, to ensure this review provides up-to-date information, preference is given to data from the last ten years since Further publications were gathered from a manual search of the reference lists of articles and reviews, and from discussion with field Meet free xxx singles in Schwarzenberg ky. A thorough literature search revealed that information was not always available regarding nutrition physiology, deficiency and supplementation of nutrients.

Information on nutrients was included in this review only when evidence was available. The information in this review can be categorized as pertaining to either maternal health or fetal and child health. The literature for maternal health included only those titles discussing pregnant mothers, mothers who are less than two years postnatal, and mothers who are breastfeeding.

Articles discussing the period pre-conception and women beyond two years postnatal were not included. The included literature for fetal and child health included titles discussing healthy embryonic and fetal development, neonates born at term, and healthy infants and toddlers up to two years old. The purpose of this review is to report outcomes related to usual and expected pregnancy and development, therefore disease states and unusual growth and development were out of scope.

For mothers, articles discussing chronic illness, pregnancy complications, or poor birth outcomes, maternal hospitalization, maternal gastric bypass, and maternal, enteral or parenteral nutrition, were not included. For the child, articles discussing abnormal fetal development, birth defects, premature infant development, abnormal child development, child hospitalization, and child enteral or parenteral nutrition, were not included.

The physiological changes that occur during pregnancy are unique in the life of women. These changes are normal adaptations that occur to nurture the developing fetus and to prepare the mother for a healthy labor and delivery [ 2 ]. These changes begin immediately after conception and affect organ systems including the cardiovascular, endocrine, gastrointestinal, hematological, respiratory, and skeletal system [ 3 ].

For women who experience a normal and healthy pregnancy, these changes typically resolve after birth with minimal residual effects. Table 1 provides an overview of the major physiological changes that occur during pregnancy. Information for this table collected from [ 34 ]. Physiological changes during pregnancy result in changing nutritional needs. During the first 2—8 weeks of pregnancy, foundational growth of the fetus occurs, and the nutrition status of the mother impacts early embryonic development, organogenesis, and neural development.

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During the second and third trimesters, fetal nutrients accumulate to be used after birth; therefore, it is critical to have an adequate supply of all essential nutrients. Optimal nutrition status during pregnancy is critical, as it impacts early embryonic development, organogenesis and neural development.

The body can be extremely sensitive to damage caused by internal and external harmful exposures alcohol, medications, environmental toxinsand these exposures can trigger major or minor functional and structural fetal defects Figure 2.

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Similarly, the body is sensitive to diet and nutrition. For example, in the presence of a healthy diet that delivers adequate amounts of key macro and micronutrients, fetal growth and development typically thrive [ 1 ]. Why Nutrition Matters: a timeline of critical events during pregnancy and early development, and the role of nutrition. Information for this table collected from [ 789101112 ].

Adequate nutrition is especially critical for normal central nervous system development. Neurological development is extremely rapid during the first days of life, with changes occurring from post conception day 18 up until age two. Nerve cells proliferate at an extremely rapid pace, especially during early fetal development [ 6 ].

This growth culminates in a network of billions of neurons and trillions of neural connections by the time of birth [ 6 ]. During fetal and early childhood development, the prefrontal cortex, hippocampus, and sensory systems undergo tremendous development that will not be able to occur later in life [ 1 ] Figure 2.

Regarding energy requirements during pregnancy, extra calories should come from nutrient-dense foods to support a healthy pregnancy weight gain [ 5 ]. The carotenoids lutein and zeaxanthin play important roles during the development of the infant eye and brain.

Lutein and zeaxanthin have been found to accumulate in the eye of fetuses as early as 17 to 22 weeks of gestation [ 131415 ]. Therefore, the mother must have adequate lutein consumption to supply her own needs along with the needs of her unborn .

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Lutein levels in both cord blood and maternal plasma peak during the third trimester, a period of active retinal and neural development [ 1819 ]. Lutein has also been found to be present at higher amounts in cord blood compared to other carotenoids [ 162021 ]. Additionally, of the carotenoids present in the placenta, lutein and zeaxanthin were the most prevalent and levels were ificantly correlated with levels in maternal serum and infant cord blood [ 22 ].

Lutein and zeaxanthin have established roles as antioxidants and visual filters. Their presence in the eye may serve as a protective factor against oxidative damage during early development due to the high metabolic activity of this tissue, abundance of long-chain polyunsaturated fatty acids, and vascularity.

Beyond protection, these carotenoids also support neuronal development via stabilizing microtubules [ 23 ], enhancing gap junction communication [ 24 ], improving vasculature [ 25 ], and stabilizing and modifying the permeability of membranes [ 26 ]. Choline, a precursor to acetylcholine, is an essential nutrient that aids in cell membrane aling and transporting lipids via lipoproteins [ 27 ]. Choline is also required to synthesize phospholipids including phosphatidylcholine and sphingomyelin, both of which are essential components of cell membranes.

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During pregnancy, the requirements for choline increase because of elevated maternal demand and the rapid division of fetal cells [ 28 ]. Choline can also influence stem cell proliferation and choline insufficiency can promote cellular apoptosis. As a result of insufficiency, brain and spinal cord structure may be altered, increasing the risk for neural tube defects [ 27 ].

Beyond its ability to synthesize neurotransmitters and molecules necessary for normal functioning of the human body, choline also plays a vital role in cognitive development. During the later stages of pregnancy, the hippocampus the memory center of the brain develops and continues to develop after birth and up until four years of age. New evidence also suggests that sufficient maternal choline intake during pregnancy and lactation can have long-lasting beneficial neurocognitive effects on the offspring [ 29 ].

Furthermore, cross-sectional data also reveal that consumption of choline from foods and beverages is not optimal. Data from What We Eat in America, NHANES —, demonstrate that women of childbearing age, 20 years and over, consume about mg per day of choline from foods and beverages, which is considerably below the Adequate Intake AI recommendation of mg per day for non-pregnant women and even further below the recommendation for pregnant women mg per day. Ensuring that women of childbearing age receive optimal amounts of choline in their diet should be made a public health priority, to decrease risk for neural tube defects and to foster the healthy growth and development of young children [ 30 ].

Folate is a B-vitamin important for both fetal and maternal health, functioning as a coenzyme critical for DNA synthesis and amino acid metabolism. Folate is a generic term that includes both the naturally occurring forms of the vitamin from food or folic acid, a form commonly found in dietary supplements and fortified foods.

For women of childbearing age, folate is critical to normal neural tube development the area from which the brain and spinal cord form in the fetus within 28 days of conception. Meet free xxx singles in Schwarzenberg ky of the other major functions of folate is that it provides single carbon units for the synthesis of nitrogenous bases purine and pyrimidine and amino acid metabolism, making folate essential for DNA synthesis [ 31 ].

Iodine is a micronutrient that works in tandem with the thyroid gland. The thyroid gland uses iodine from food to make two thyroid hormones including thyroxine T4 and triiodothyronine T3. In the fetus, iodine is important for normal brain and nervous system development [ 33 ].

Iron is a trace mineral that is required for fetal growth and development, because it serves as a cofactor for enzymes involved in oxidation—reduction reactions, which occur in cellular metabolism. Iron is also a major component of hemoglobin, the protein that allows red blood cells to carry oxygen throughout the body. Pregnancy also requires a large expansion in blood volume to meet the demands of the growing fetus. Meeting the iron recommendation of 27 mg per day is especially important during the last trimester of pregnancy, since the fetus accumulates iron for use during early life.

Research has shown that if pregnant women are iron deficient, and, consequently, iron is not available to the infant in the first six months of life, there can be lifelong irreversible neurological effects [ 35 ].

Furthermore, women who meet iron requirements during pregnancy may provide an advantageous impact on cognitive development in their children [ 3637 ].

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In the first year of life, iron continues to play a vital role in neurodevelopment. During this time, the brain experiences a considerable transformation, becoming a complex organ. Several neurodevelopmental processes occur, including synaptogenesis, the organization of neurotransmitter systems, and the onset of myelination, especially within the hippocampus, visual and auditory systems.

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Nutritional Gaps and Supplementation in the First Days