Nieman: Early reading and good nutrition aid in building brainpower

Having been a pediatrician for the past 36 years, I always wondered what it would be like to be a grandparent one day. The good news is that my wife and I became grandparents for the first time in October 2022.

My daughter gave birth to a very cute little girl with lots of hair, a calm disposition and health bordering on perfection in terms of sleeping, eating and growing. When a mom in my clinic asked about our grandchild, Charlie, I learned that my daughter has a trick baby. This mother introduced me to an amusing concept: when a baby is close to perfect, that baby tricks its parents into having another baby, and the second baby is not always “perfect.”

I have always been curious about early brain development and the many factors which play a role in laying the proper foundations for optimal brain health. It is a rather complex topic because so many variables come into play. Toxic stress seems to be a particularly important factor. The pioneering research done at Harvard made us aware of psychosocial stressors, early trauma, chronic pain and socio-economic factors all playing major roles.

Jokes have been made about grandparents who swear their grandchild is the smartest human being around. I certainly do not want to fall into that subjective trap, but two recent anecdotes – one humorous and the other scientific – made me ponder the future of my grandchild’s brain.

In one instance, I walked into my exam room and found an eight-year-old boy reading a thick book. I told him, “I bet you take a few weeks to read that book.” With confidence he responded, “No … I will finish reading it in less than two weeks.”

I love books and our home may have a few too many according to my dear wife. So I asked my patient to help me out. I asked him to write a note to my wife explaining why books matter a lot if one wants to be smart.?

This is what he wrote: “The more you read, the more you learn. So you can never have to much book’s.” (His spelling is un-edited here.wow.)

Many parents try to get their children to read in order to stimulate optimal brain development, but it is not always easy. A popular parenting website, healthychildren.org, suggests parents model good behaviour, read with children before bedtime, get library cards, read what children read, participate in virtual story times, create a reading nook, read with friends, keep books strewn all over the home, travel with books and encourage friends and family to gift books for birthdays and holidays. We know that when books are a part of the family routine, kids’ language skills grow.

The scientific event about a healthy brain was an article in Pediatrics. A well-known research group based out of Toronto Sick kids,?TARGet Kids,?recruited healthy children who were seen for primary care visits. These children were aged between 12 to 40 months. They were screened for iron deficiency anemia and nonanemic iron deficiency.

In a landmark longitudinal study conducted in Costa Rica in the 1980s, children with iron deficiency, compared to good iron status in infancy, had eight to nine points lower cognitive scores up to 19 years of age.

The Toronto researchers were curious if, in a high-resource setting, low iron levels would be associated with later diminished cognitive functioning. The results showed that the iron-sufficient group had cognitive superiority and their visual reception scores also were significantly higher than the iron-deficient group.

When pediatricians see patients who are exclusively breastfed beyond six months of age, and when babies are not provided with iron-fortified cereals at the appropriate time, or where there is poor utilization of iron-rich foods, we know to screen for low iron? – certainly never later than one year of age. Currently, the American Academy of Pediatrics recommends screening all infants at the age of one year for anemia (a low hemoglobin) or a low ferritin level. ??

In an editorial in Pediatrics, December 2022, Drs. Frank Greer and Robert Baker claim that screening for low iron in the absence of risk factors remains a conundrum. With tongue-in-cheek humour, these academic authors state that “future studies will iron out this conundrum.”

Based on my own experience with Charlie so far … I am going to suggest only two ideas:

Until proven otherwise, believe that your grandchild is smart and unapologetically and freely share cute photos with strangers. Somehow, photos of innocent, cute babies bring much joy, which is good for?our?brains. And pay attention to helping early brain development – especially when it comes to books and healthy eating.

Dr. Nieman is a community pediatrician, marathon runner, author and health coach. drnieman.com?