![]() For example, behaviors such as working memory, set-shifting, multi-tasking, and attention that are not present in the neonate nevertheless have their neural ontogenies prior to term birth. Despite the lack of behavioral manifestations, the neural circuits underlying more complex behaviors that will appear later in childhood are being constructed ( 3, 4). Other brain functions that are being supported through this burst of circuit development and connectivity do not have obvious behavioral manifestations at birth. ![]() More complex behaviors such as recognition memory, dependent in large part on hippocampal development, can even be demonstrated in the term and preterm neonate ( 3, 4, 5). Examples of these early developing circuits include primary sensory systems such as hearing, touch and pain sensation, taste and, to a lesser extent, vision ( 3, 4). Some fundamental behavioral functions are already present at birth, implying that structural connectivity of the relevant brain circuits have begun. As these cells become more complex and interconnected, brain functional capacity increases. The increased physical complexity reflects the rapid rate of neuronal and glial growth and development within the brain. Even during the first four months of that time span, from 24 weeks to 40 weeks PCA, the brain changes from a smooth, bi-lobed, and relatively non-complex organ into one characterized physically by the sulci and gyri more typical of the adult brain. The newborn human brain undergoes a remarkable transformation in form and function beginning at the age of extra-uterine viability at approximately 23-24 weeks post-conceptional age (PCA) through the first two years of life ( 3). Therefore, a timely question is whether appropriate assessments and interventions are being made during the period of greatest vulnerability to the developing brain: from fetal life through the first two years of postnatal life. Recent studies suggest that the window for nutrition is in late fetal and early postnatal life with greater and greater recognition that postnatal nutritional success is highly dependent on optimizing fetal nutritional status prior to birth ( 1, 2). An important issue is to identify more precisely the sensitive time windows within which to provide nutritional interventions in order to promote optimal neurodevelopment in children ( 1). Of these, nutrition falls in the direct purview of medical caregivers and can be optimized to promote neurodevelopment or can be ignored and thereby confer a risk to the developing nervous system. ![]() ![]() Nevertheless, there are important and controllable environmental factors that profoundly influence early brain development including nutrition, reduction of toxic stress and environmental enrichment ( 1). Much of brain development in early life is highly pre-programmed and is to a great extent experience-independent. One of the most important relevant long-term health outcomes of early life experience is neurodevelopment. ![]()
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