From breastfeeding to physical activity: here are the six A's to best raise your baby in the first thousand days

Good first. Or rather the first thousand days, that period from conception to the baby's second birthday. Days so crucial for the child's future that this year they are the focus of World Health Day, celebrated every year on 7 April. With the message 'A healthy start, a future full of hope', the aim is to renew a concept that is as simple as it is crucial: adult health starts in childhood. "More and more studies," says President of the Italian Society of Paediatrics Rino Agostiniani, "emphasise the role of epigenetics, or how the environment influences gene expression, with changes that can be passed on to future generations. For this reason, the first thousand days of life are a crucial period in which factors such as diet, sleep, stress and, as anticipated, the environment in which a child grows up can have a lasting impact on its health and development. These factors can turn certain genes on or off, influencing the risk of future diseases, such as diabetes or cardiovascular disease'.

To guide families, educators and paediatricians along this path, SIP, the Italian Society of Paediatrics, proposes a clear and practical approach: the '6 A's'. These are six fundamental actions that, if adopted from an early age, can promote healthy growth in children and adolescents, improving the quality of life also in adulthood. A vademecum that is a guide to building the foundations for lasting well-being.

The World Health Organisation recommends exclusive breastfeeding for the first six months of life because 'breast milk is an essential food for the infant, not only for its nutritional value, but also for its protective properties. Thanks to the antibodies and immunological substances it contains, breast milk helps to strengthen the baby's immune system, making it more resistant to infectious diseases. This natural immune support is particularly important in the first months of life, when the baby's immune system is still developing. Breastfeeding, therefore, not only nourishes but also protects the infant, reducing the risk of respiratory infections and promoting healthy growth,' Agostiniani emphasises. And as the baby grows, it is essential to adopt a balanced diet to maintain good health. The best choice is to follow the Mediterranean diet, which has been recognised by Unesco as an Intangible Cultural Heritage of Humanity. "Focus on plenty of fruit and vegetables, pulses, whole grains, olive oil and limited consumption of red meat. It is important to avoid packaged foods and sugary drinks, while it is advisable never to skip breakfast and to eat varied, simple and balanced meals'. The Italian Society of Paediatrics (Sip) suggests the Transcultural Food Pyramid. Not only pasta and rice: sorghum, millet and quinoa enter children's plates. Bamboo shoots and cassava leaves alongside tomatoes and aubergines. And for fruit apples, oranges, cherries, but also litchis and papaya.

From diet to physical activity is a short step, as both are essential pillars of a healthy lifestyle. Regular exercise is crucial for the physical and mental development of children and adolescents. The World Health Organisation (WHO) recommends that young people, aged 5 to 17, engage in at least 60 minutes of physical activity per day, whether moderate or intense. "In this regard,' Agostiniani emphasises, 'the invitation is also to encourage free play and where there is the possibility, for example walking to school'. Exposure to screens is also an increasingly relevant issue in daily life, especially for children and adolescents. It is essential to manage and control the time spent using electronic devices such as smartphones, tablets and computers to avoid negative effects on physical and mental health. This is why the Sip has made recommendations that "include avoiding the use of smartphones and tablets in children under 2 years old; limiting it to a maximum of 1 hour a day for children between 2 and 5 years old; and no more than 2 hours a day for those between 5 and 8 years old. It is also recommended to avoid the use of devices during meals and before going to sleep so as not to interfere with eating and sleeping habits'.

Rested child means gained health. This is how one could summarise the benefits of sleep, a key element in the healthy growth and development of children. The American Academy of Sleep Medicine provides the following indications on sleep duration: Infants (0-3 months): 14-17 hours a day; Infants (4-12 months): 12-16 hours a day, including naps; Toddlers (1-2 years): 11-14 hours a day, including naps; Preschoolers (3-5 years): 10-13 hours a day, including naps; Schoolchildren (6-12 years): 9-12 hours a day; Teenagers (13-18 years): 8-10 hours a day. "A table," explains the Sip president, "that aims to give indications on the amount of sleep, because during sleep the body and mind of the little ones regenerate, favouring physical growth, strengthening of the immune system and consolidation of memory and learning". Vaccines are a fundamental tool for preventing many infectious diseases. Following the national vaccination calendar and participating in recommended immunisation campaigns not only protects the individual, but also the community, helping to prevent the spread of serious diseases. For further details and advice, it is always useful to contact your paediatrician,' Agostiniani concludes.