This thematic issue of Ciência & Saúde Coletiva, focused on aspects of child health, presents the reader with articles relating to different aspects of the first years of life and includes two surveys with pregnant women.

This approach is in line with the concept of the “first 1,000 days,” which comprises the combined period of gestation and the first two years of the child’s life. This cycle is considered a window of opportunity for health care. There is scientific evidence that, in this period, it is possible for epigenetic changes capable of interfering in the development of the human being to occur, thereby benefiting or prejudicing the entire life cycle of the individual and, consequently, of society.

Actions that ensure adequate nutrition and early stimulation in this phase of life contribute to the formation and development of the child’s brain, resulting in short-, medium-, and long-term health gains. Two series of The Lancet journal (in 2008 and 2013) addressed maternal and child malnutrition. The first drew attention to the specific nature of the first 1,000 days of life and the need to prioritize them in the formulation of public policies and in areas of care for pregnant women and infants. The second publication described “the dietary, behavioral and health determinants that lead to optimal nutrition, growth and development and how they are affected by underlying food security, caregiver resources and environmental conditions, which in turn are shaped by economic and social national and global contextual conditions”¹1 Cunha AJLA, Leite AJM, Almeida IS. The pediatrician's role in the first thousand days of the child: the pursuit of healthy nutrition and development. Pediatr (Rio J). 2015; 91:S44-S51..

Ensuring adequate nutrition and development is expected to reduce childhood morbidity and mortality, improve children’s cognitive, motor and socio-affective development, social performance and learning ability, increase height and decrease adult obesity and chronic degenerative diseases, and increase work capacity and productivity¹1 Cunha AJLA, Leite AJM, Almeida IS. The pediatrician's role in the first thousand days of the child: the pursuit of healthy nutrition and development. Pediatr (Rio J). 2015; 91:S44-S51.. It is important to emphasize that maternal nutrition, and the skills acquired by women throughout their lives, interfere directly in the nutrition and development of children who depend on it, hence the importance of investing in public policies aimed at this segment of the population.

Based on international studies in the 21st century on the origin of the development of health and disease processes, the Brazilian Association of Nutrology proposed increasing the 1,000-day period to 2,200 days (100 days before conception + 270 days of gestation + 1,830 days from the first to the fifth year of life). This proposed extension is due to the fact that studies have shown the impact of several parent-related conditions on child health even before conception, in addition to the finding that the development of the central nervous system and microbiota continue after two years of age²2 Nogueira-de-Almeida CA, Ribas Filho D, Weffort VRS, Ued FV, Nogueira-de-Almeida CCJ, Nogueira FB, Steiner ML, Fisberg M. First 2,200 days of life as a window of opportunity for multidisciplinary action regarding the developmental origin of health and disease: positioning of the Brazilian Association of Nutrology. Int J Nutrol. 2022; 15(3):1-21.. The expansion of the window of opportunity period involves men’s health care in the preconception phase, which is a challenge. Professionals need to encourage them to attend health care units for guidance on healthy lifestyle habits, disease prevention, and early identification and treatment of existing diseases.

It is important to emphasize that this care, whether in the first 1,000 or 2,200 days of life, needs to be individualized, proposed in context with the reality of each father, mother, child, the environment in which they live and the conditions of the health services to which they have access. The articles in this issue of Ciência & Saúde Coletiva shed light on some care strategies by addressing topics such as infant mortality, line of care, prenatal care, avoidance of hospitalization, breastfeeding, and feeding habits up to two years of age, among others.

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