Nutrition, parenting style and early childhood experiences all affect brain development in children, writes Meera Murugesan
WHEN my daughter was born, like any new mum, I fussed and fretted over her diet and I haven’t stopped even though she’s now 7. I still worry about what she’s eating, how much she consumes and whether she’s getting enough fruit and vegetables in her diet.
Good nutrition is crucial for a child’s brain development so while mothers may huff and puff and struggle with a fussy eater or demanding child, we still try every trick in the book to get some goodness down their throats. But nutrition and brain development is not a subject one can only tackle after birth.
Brain development actually starts in the first 1,000 days of life, which means from conception right up to the child’s second birthday, says Rozanna Rosly, head of dietetic services at UM Specialist Centre (UMSC). This is the crucial time for brain development and the reason why pregnant women are prescribed supplements such as folic acid, iron, calcium, Vitamin D and DHA.
“There are nutrient and brain interactions during these crucial 1,000 days. It’s very important for expectant mums to have proper nutrition, right from the time they plan on having a baby,” says Rozanna.
The most rapid period of brain growth happens in the last trimester so what the mother consumes can make a huge difference. And once they deliver their babies, the first “brain food” the baby receives is breast milk.
Breast milk contains just the right balance of nutrients such as fats, proteins, lactose, vitamins, minerals and water for newborns.
More importantly, says Rozanna, breast milk plays a key role in a child’s brain development because it is rich in Omega 3 and Omega 6 fatty acids (DHA and AA), taurine, choline, zinc and many other nutrients that support this process.
“While there’s no guarantee that breast milk will turn your newborn into the next Einstein, it will help your infant’s brain to achieve its maximum potential,” she stresses.
Numerous studies have proven the connection between breastfeeding and positive neuro-developmental gains. Studies have linked breastfeeding to higher IQ, mastery of developmental milestones and improved cognitive and academic performance. But Rozanna says parents need to keep in mind that both over nutrition and under nutrition can have an impact on brain development.Children should not be eating too much and becoming overweight, or too little and being underweight or stunted.
However, in Malaysia, we are facing both these problems.
The National Health and Morbidity Survey 2016 revealed that there is still a high prevalence of stunting (20.7 per cent) and underweight (13.7 per cent) in children below 5.
At the same time, the prevalence of overweight has increased to 6.4 per cent. In its 2016 report, “Overcoming Childhood Obesity and Malnutrition in Malaysia”, the United Nations Children’s Fund (Unicef) also states that Malaysia is one of several Asean countries facing a simultaneous crisis of over and under nutrition.
The Seanuts Malaysia survey carried out in 2011 also indicated that over-nutrition is a problem in the country. There was a higher prevalence of overweight (9.8 per cent) and obesity (11.8 per cent) compared to thinness (5.4 per cent) and stunting (8.4 per cent) among children surveyed.
Rozanna explains that while the brain requires all nutrients for growth, certain nutrients such as protein, polyunsaturated fatty acids, iron, zinc, copper iodine, folate and vitamins A, B6 and B12 are particularly critical. She says after the breastfeeding period, the best approach parents can take is to ensure children have a well-balanced diet which includes a variety of food from different food groups so they get a wide range of nutrients.
Assuming that only certain foods such as superfoods can improve brain development is wrong because there is no one food that can boost brain development. Children need a variety of nutrients from various foods.
“Too much or too little is unhealthy when it comes to food and nutrition. It is important to eat the right and sufficient amount following the recommended age-appropriate servings for each food group.”
DON’T MILK IT
The tendency to frequently replace proper meals with milk is also not the right approach for children. Many parents are taken in by advertisements for growing-up milk which indicate a whole host of benefits, including boosting brain development. As a result, they assume that as long as the child drinks milk, he is fine even if he does not eat properly at main meals.
Rozanna says the rule should be solids before milk because if you give too much milk the child will be too full to eat proper meals.
“Milk is a supplement to your main diet. It has many benefits but it is not a magic pill which can take over the main diet. If the child has some form of physical or mental disability or medical condition which impairs his or her swallowing or chewing ability, then the child may need to be on a liquid or liquidised diet.”
She also cautions that high calorie milk formulations may lead to weight gain if given in excess. So the child, in the journey to promote brain development, could be gaining fats.
Rozanna says one has to first look for any inadequacy in the child’s diet before introducing high calorie formulations and the milk given has to match the child’s needs. Too much or too little of anything will be detrimental. “At the end of the day, it’s all about balance,” she says.
ESSENCE OF BRAIN DEVELOPMENT
WHILE most nutrients are needed for brain cells to develop, mature and function, the combined nutritional deficiencies of zinc, iron and iodine have been shown to lower a child’s intelligence quotient (IQ), says Dr Raja Juanita Raja Lope, consultant in developmental and general paediatrics at Pantai Hospital, Kuala Lumpur.
Besides nutrition, experiences and input from the environment are also essential for normal brain development, she adds.
Poor quality sensory, language, emotional and social input, for example, can hamper brain development. Genetics also plays a role. But associating brain development with only academic performance or classroom intelligence is too narrow a definition, stresses Dr Raja Juanita.
“Brain development refers to the complex processes at a genetic and cellular level interacting with the environment over time, which results in skills and abilities in a child. These skills may be motor, cognitive, perceptual, language, social and more.”
Early exposure to music, art or other extra-curricular activities can also boost brain development in a child.
Dr Raja Juanita says studies have shown that learning to play a musical instrument, for example, helps develop attention and processing skills in normally developing children. Children exposed to language-rich environments also have better language abilities, sports helps with motor and social skills, and art with fine motor (hand) skills and creativity.
On the other hand, too much screen time, inadequate stimulation, not providing sufficient quality time and not providing a supportive, enriching environment can have a negative impact on brain development. A very punitive style of parenting can also be detrimental.
“Expose your child to a variety of activities, but be sensible and don’t overdo it. Children are increasingly experiencing over-scheduling, resulting in anxiety and stress.”
What children need for good healthy brain development is free time to play and explore and rest. Play enables a child to socialise, share, develop unique interests, make decisions and resolve conflicts. It is an essential part of a healthy upbringing.
HEALTHY MEALS MEAN HEALTHY MINDS
TO help your child eat right for good, healthy brain development, practise these simple steps:
1. Provide age-appropriate foods and portions
Keep portions small but allow your child to ask for additional helpings.
2. Feed to encourage appetite
Provide three main meals and one to two snacks. Don’t serve snacks or milk within an hour of a meal.
3. Frequently offer new foods along with familiar foods
It may take up to 10-15 times of trying before your child accepts new food. Don’t force him if he turns away from a particular food, but try again another time.
4. Enjoy mealtimes together as a family without distraction
Put away toys, books and electronic gadgets during meals to promote bonding and food education.
5. Encourage independent feeding
Cut food into small pieces (bite-sized) that your child can hold to self- feed. Accept and tolerate the mess that will come!
6. Maintain a neutral attitude
Praise your child when he or she feeds on their own but avoid using food to reward your child.
7. Limit meal duration
End meal times within 20-30 minutes, even if your child has eaten very little.
8. Consider time-out
Have a spot where your child can be sent to if he or she misbehaves at the dining table. When the child is calm, explain what he or she did wrong.
Source: “My Growth Diary” —3 IMFeD Childhood Feeding, Nutrition & Growth Programme, Malaysian Paediatric Association & Abbott.