About the Author

Mary Brown, MD., of Bend, Oregon, is a past member of the board of directors, American Academy of Pediatrics.

“Vitamin N” and the American Academy of Pediatrics

A walk in the woods, climbing a tree or patiently watching a fish rise to a dry fly will not solve everything, but it could go a long way to bring things into a more positive, hopeful perspective. Richard Louv’s “Vitamin N” (the health benefits of time spent in nature) should find its place in the list of Essential Vitamins!

The American Academy of Pediatrics (AAP) is an organization of 57,000 pediatricians in the United States and Canada dedicated to advancing the health and well being of children, adolescents and young adults through advocacy, education, research, service and policy.

The AAP is perhaps the strongest political voice for children (who don’t vote and contribute to campaigns and are often left out of political conversations) in this country. I have been proud to serve on the AAP Board of Directors for the last six years representing District VIII (14 western states including Alaska, Hawaii, the Military Pediatricians west of the Mississippi and 2 Canadian Provinces). We believe in the inherent worth of all children — they are our most enduring and vulnerable legacy.

The changing threats to children’s health

The morbidities threatening children and challenging pediatricians in the past were primarily infectious diseases and infant mortality. Vaccines, antibiotics and advances in prenatal and neonatal care have markedly reduced these. Today’s morbidities are much more complicated, but equally threatening to our children and grandchildren. These will take more than a parent, a pediatrician, a teacher and a “village” to solve. These new challenges are secondary to changing emotional, social, economic and demographic factors.

Children in poverty are especially vulnerable. It will take a country that values children and prepares them to become healthy and happy adults ready to contribute to society. A return to nature will contribute to solutions for all these morbidities.

Recent science has shown the negative impact of early brain exposure to stress with life-long academic and health effects. An excellent ongoing study funded by the Centers for Disease Control and Prevention and Kaiser Permanente is titled ACE (Adverse Childhood Experiences). Even the structure of the adult brain is altered by these adverse childhood experiences.

Help from the AAP

The Strategic Plan of the AAP has many priorities that can be positively influenced by re-connecting with nature and preventing the “Last Child in the Woods” from ever happening. Specifically, Mental Health, Obesity, Early Brain and Child Development, and Children with Special Health Care Needs including those in Foster Care.

The AAP produces policy statements to help guide the pediatrician’s ability to give the best evidence based care to children and parents and to help guide advocacy on the local, state and national levels. A statement published in Pediatrics (the official journal of the AAP) is titled “The Lifelong Effects of Early Childhood Adversity and Toxic Stress.” It clarifies why Early Brain and Child Development is a priority of the AAP.

Another policy statement is “Prevention of Overweight and Obesity” that recommends that pediatricians “routinely promote physical activity, including unstructured play at home, in schools, in child care facilities and throughout the community.” In addition this statement advises limiting screen time (TV, video and non-academic computer time) to less than 2 hours a day. The Academy has joined Michelle Obama’s “Let’s Move” campaign. Many pediatricians have begun to give parents a prescription for nutrition and activity (RX for Healthy Living, Rx to Thrive, etc.).

In my community, Bend Oregon, we have partnered with our Parks and Recreation Department and the other 12 partners in our Deschutes Children’s Forest Grant to make this Rx to Thrive more than just a piece of paper.

Mental Health is another AAP priority. Currently, 14 million children and adolescents have some mental health disorder. Suicide has become a leading cause of mortality in adolescents and young adults. Very often we lose the best and brightest because no one bothered to give them hope. An adult who listens and cares can change the course of that life.

The AAP also offers a public/parent web site with many links to the many ages and stages of child development and the challenges and questions that come from the best and hardest job in the world — being a parent!

Nature’s role

Nature can help even the playing field. Health disparities like race, gender, poverty, disability and family structure have less stressful impact on a child’s life if there are safe and accessible places for children to play and use their wonderful imaginations.

Two more AAP policy statements that relate to the importance of nature are “The Built Environment: Designing Communities to Promote Physical Activity in Children” and “Creating Healthy Camp Experiences” discuss the importance of safe, unstructured play.

These experiences have been proven to have lasting effects on psychosocial development including self-esteem, independence, leadership, values, and willingness to try new things. If we stress a connection to the natural environment, as “Last Child in the Woods” and “The Nature Principle” emphasize, we can lessen the lifelong effects of a stressful childhood including depression, obesity, behavior problems, drug use and risk-taking behavior.

Mary Brown, MD., of Bend, Oregon, is a past member of the board of directors, American Academy of Pediatrics.

More resources:

The Making of a Children’s Forest

The “Vitamin N” Prescription

Grow Outside: Tools & Resources for Pediatricians



Comments (2)

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  1. Howard Frumkin says:

    Thanks to a wonderful and wise pediatrician for this message. It’s gratifying to see more and more medical evidence on the benefits of nature contact, and it’s gratifying to see the prestigious American Academy of Pediatrics acting on this evidence in several ways. What could be better than a prescription that both prevents and treats “depression, obesity, behavior problems, drug use and risk-taking behavior”–and makes children happy, reverent, and self-sufficient?

  2. Denise Dahn says:

    Thanks for this great post. I think a lot of parents are concerned that their kids prefer to sit on the couch in front of a screen instead of playing outside. We need to find a way to make nature fun again. I think our society has become over-the-top concerned about safety to the point where kids are not even allowed to walk to school anymore. Is it really that dangerous Out There? Whatever the perceived dangers of Outside are, they can’t be worse than the real, statistical dangers of simply driving in a car. And certainly not as unhealthy as sitting inside and watching TV. Thanks for your good work!

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