Punta Cana declaration, of the Latin American Association of Pediatrics for the prevention of non-comunicable diseases

Abstract

Noncommunicable diseases (NCDs) constitute the most significant cause of morbidity and mortality in the Americas, and the health of future generations begins to be forged before conception declares the following:

Recognizing the right to entire life and reaffirming the concepts of the Convention on the Rights of the Child and development to receive preventive and appropriate prenatal and postnatal health care with guidance on basic health principles, the importance of breastfeeding, nutrition, and environmental care in pre- and postnatal life,

Building health in the course of life is essential for fulfilling the Sustainable Development Goals, including "guaranteeing a healthy life and promoting the well-being of all at all ages."

THAT the preconception, gestational and postnatal period, up to the first two years of life, represents the stage of greatest vulnerability in the human being, during which adverse nutritional and environmental conditions can determine diseases in adult life and even be transmitted to generations following and,

THAT this early interaction can leave a mark that interferes with the development of the potentialities of the human being,

THAT the scientific evidence of the last decades has reinforced the knowledge of the fetal origin and early stages of child development in adult diseases, known as the DOHad concept (an acronym for Developmental Origins of Health and Disease), being this is the key to the origin of specific NCDs,

THAT the health team involved in the care of mothers and children, especially at the first level of care, must prioritize this stage and consider it an opportunity advantage for adequate counseling aimed at promoting comprehensive development and preventing diseases that manifest themselves in the course of life,

THAT adverse environmental conditions in pregnant women can cause a severe and lasting effect on neurodevelopment, metabolism, and reproductive health throughout life and even be transmitted to subsequent generations.

Under this evidence that redefines the conditions of good perinatal and pediatric care, due to its implications in individual diseases in adult life and even in their offspring, the presidents of the affiliates commit to working on the prevention of noncommunicable diseases by promoting the following:

- Healthy habits of women and their partners before, during, and after pregnancy.

- Adequate prenatal and perinatal care, ensuring access for the mother and the newborn to institutions categorized by level of complexity and risk.

- exclusive breastfeeding during the first semester and continued breastfeeding for up to 2 years or more, with the incorporation of a healthy and adequate complementary diet from 6 months and reinforcing the importance of the mother-child affective bond,

- The growth and healthy development of childhood, reinforcing the knowledge of the tools for the early detection of its alterations,

-Dissemination of the concept of fetal origin and the early stages of child development in adult disease in the health team at the first level of care to base prevention activities on women's health care. Women and children-

-The implementation of community education programs providing the population with the knowledge to protect maternal and child health and preserve the environment.

- Healthy environments, avoiding toxic exposures and reinforcing the importance of guaranteeing good air, water, and food quality for pregnant women and children.

-The inclusion of issues related to the risks of adult diseases from prenatal or childhood exposures in the training axes and scientific activities.

- Research to achieve local and regional diagnoses of these issues.

-Advocacy for compliance with the Code for the Marketing of Breast Milk Substitutes.

-The creation of effective measures in public policies to safeguard the health of present and future generations.

We know that the best way to advance in pursuing these objectives is to act in an interdisciplinary and intersectoral manner, with the articulation and integration between professionals and different social actors interested in the care of mothers and children, according to the possibilities and idiosyncrasies of each country. As Scientific Societies, we commit our efforts to prevent NCDs, confirming our responsibility to ensure the well-being of children and adolescents in our region and for better health for future generations.

Punta Cana, September 30, 2022.

Abbreviations

LM: Breastfeeding.

NCDs: noncommunicable diseases.

 Supplementary information

No supplementary materials are declared.

Acknowledgments

The members of the societies participating in the Punta Cana meeting are acknowledged and thanked.

Financing

The authors financed the expenses incurred in the production of this research.

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Conflicts of interest

The authors declare they have no conflicts of interest.

* Information from the authors, members of ALAPE

Mirza Yamileth Lara Castillo, Pediatric Association of Honduras.

Rodolfo Pablo Moreno, Argentine Society of Pediatrics.

Ricardo Do Rêge Barros, Brazilian Argentine Society of Pediatrics.

Rossana Faúndez Herrera, Chilean Society of Pediatrics.

Victor Hugo Velazco, Bolivian Society of Pediatrics

Rubén Ruiz, Latin American Association of Pediatrics.

Mauricio Guerrero Román, Colombian Society of Pediatrics.

Julia Fernández, Costa Rican Association of Pediatrics.

Luz Herrera, Dominican Society of Pediatrics.

Joanna Acebo A, Ecuadorian Society of Pediatrics.

Oswaldo Revelo Castro, Latin American Association of Pediatrics.

Luis Carlos Blesa Baviera, Spanish Association of Pediatrics.

Mónica Pujadas Ferrer, Uruguayan Society of Pediatrics.

Gerardo Tosca Claudio, Puerto Rican Society of Pediatrics.

Marcela Fama Pereira, Colombian Society of Pediatrics.

Mario Encinas Arana, Peruvian Society of Pediatrics.

Ana Campuzano Paraguayan Society of Pediatrics.

Jesús Gerardo Guajardo Treviño National Confederation of Pediatrics of Mexico.

Perla Marina Dubon Nájera, Pediatric Association of Guatemala

Rodrigo Siman Association of Pediatrics of El Salvador

Editor's Note

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