Human development proceeds as a complex set of interdependent yet distinct and precisely integrated biological programmes. Following fertilization, developmental programmes are initiated by selective reading of the genetic code leading to the generation of the various cell types, organs and organ systems that constitute mammals. These programmes are dependent on the expression of the maternal and foetal genomes and a regulated, maternally derived supply of nutrients. In fact, most developmental programmes, including organogenesis, limb formation and central nervous system (CNS) maturation, require specific nutrients for their initiation and progression. Nutrients are required as building blocks for the synthesis of macromolecules, energy production and as biological cofactors for enzymatic reactions.
Does fate exist? Genes determine our genotype, and if fate does exist, it is, at least partly, written in our DNA. Polymorphisms likely influence the development of atherosclerosis and hypertension , insulin resistance  and osteoporosis . But genes are not the sole actors in defining the individual. Unfavourable social and economic conditions likely affect our final height, the age of sexual maturation , physical performance , intellectual skills and adaptive abilities . Could in utero malnutrition influence our «fates» to the point of “programming” our metabolic characteristics ? For example, are we condemned, even before we are born, to an early death due to myocardial infarction, to a vascular cerebral accident, or to the complications of non-insulin-dependent diabetes , simply because our birth weight was inappropriate for gestational age or because we failed to gain weight adequately during our first year of life?
The American Academy of Pediatrics (AAP) recommended in 1994 that “in families with a strong history IDDM (insulin-dependent diabetes mellitus), particularly if a sibling has diabetes, breast-feeding and avoidance of commercially available cow’s milk and products containing intact cow’s milk protein during the first year of life are strongly encouraged” . This consensus statement represents one of the first official recommendations for the nutrition in infancy and childhood in order to prevent a disease that usually appears months to years later in life. Since then there has been a growing concern in the public that too short period of breast-feeding can lead to a number of immune-mediated diseases throughout childhood and even in adulthood.
At the dawn of the third millennium, the feeding of children during the first two years of life continues to represent a major challenge for scientists and paediatric practitioners alike. As infant mortality decreased and common morbidities were even more effectively avoided over the past century through immunization and other preventive strategies, an improvement in mean life expectancy occurred, mainly due to preventing intrauterine growth retardation (IUGR), protein- energy malnutrition (PEM) and stunting.
The Annales Nestle is now sixty years of age. Child nutrition and its fundamental bases have been at the heart of the most frequently treated subjects in the Annales since its inception, regardless of changes in the membership of its Editorial Committee. All we have learned in the last sixty years underscores the importance of this core interest. In fact, the wisdom of this consistency is reinforced steadily as the bases have become clearer for both the advantages of “getting nutrition right” in early life and the burdens imposed by the pathophysiology of its disorders. This expanding knowledge base relentlessly argues more strongly for keeping health professionals in developing and developed countries informed about how best to prevent, detect and treat nutrition related disorders.