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Epigenetics, the study of chemical modifications to DNA that regulate gene expression independent of one’s underlying genetic code, has dramatically changed our understanding of the interplay between genes and the environment. The emerging field of epigenetics has demonstrated that gene and environment interactions can directly alter human biology, which subsequently impacts developmental and health trajectories.

It is widely believed that epigenetic responsiveness to the environment varies by life stage, with the fetal and childhood stages being periods of high sensitivity in which epigenetic marks are set. The marks later stabilize, so one’s cells are effectively programmed in childhood for how they will respond to the environment throughout the remainder of one’s life. Furthermore, there is evidence to suggest that some epigenetic changes may persist from generation to generation, so the experiences in childhood may program or impact not only one’s personal developmental trajectory and health over the life course, but potentially also those of their children and generations beyond.

Because epigenetic changes are preventable and potentially reversible, there are opportunities for pediatricians, patients, and families to intervene. You see patients everyday whose health may be affected now and throughout their life by epigenetic changes.

Ultimately, epigenetics enhances and amplifies our understanding of the need to minimize and address adverse childhood experiences, and to ensure healthy environments for children. Epigenetics solidifies the biological basis for many of the pediatric health-related interventions that have long been recognized as valuable, such as smoking cessation, dietary counseling, and education - and crystallizes the need for action.

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