Many, if not all, pediatricians and educators would agree that a nutritious diet beginning at an early age is a key element to building the foundation for a healthy life.  Research has shown many health benefits to starting your child’s day with breakfast, particularly better cognitive function such as attention, memory, and concentration. It has also been shown to jump start metabolism earlier in the day to help burn calories, reducing tendencies to overeat later in the day (1,2). One meta-analysis of 40 retrospective studies with over 300,000 participants even showed that children and adolescents who skipped breakfast had an increased risk of obesity (3).

In addition to the numerous health benefits of breakfast consumption, recent studies are looking into school breakfast and its impact on chronic absenteeism in the U.S. With initial analyses showing promising effects on school attendance, school breakfast programs offer potential solutions to the absenteeism crisis (4).

The Reality Students Face

Unfortunately, the reality of food insecurity that many families face in the U.S. today has led to increasing numbers of children going without breakfast before the school day. In Virginia, there has been a notable rise since the COVID-19 pandemic in children facing food insecurity. The 2021 Virginia State Impact Report from the United States Department of Agriculture (USDA) found substantially higher reports of ‘very low food security’ in households with children in March and April 2020 (44.6%) and November and December 2020 (46.5%) compared to statewide rates in 2019 (3.9%) (5).

I witnessed the impact of the COVID-19 pandemic on food security and loss of school-provided meals in my own community. Rockingham County, Virginia is home to a diverse population of children, many of whom live on family farms miles away from town or their next-door neighbor. Some live in remote, smaller, under-resourced communities in the Shenandoah Valley. These children rely on school bus transportation as their only means of getting to school. When the COVID-19 pandemic shut down schools for the remainder of the school year and then subsequently led to virtual school platforms for the next academic year, essential school breakfast and lunch previously provided for children was suddenly taken away.  In response to this, teachers, including my own mother, participated in programs to deliver meals to students in need. We were immediately reminded why school breakfast programs are integral to pediatric health and wellbeing. Although schools are now back in person, there is still work to be done to ensure that all children receive these meals.

In the growing child, a well-balanced diet is critical for brain development, mental health, preventing chronic disease, and more. Nutrition not only consists of the quality of food consumed (i.e. nutritional value, etc.), but also a healthy quantity and access to food throughout the day. It is recommended that school aged children eat 4-5 times a day (3 meals with 1-2 snacks). Therefore, school meals, including breakfast and lunch, can play an integral part in meeting these nutritional needs for children, including providing upwards of 35-40% of daily energy needs for children and teens.

On January 13, 2025, the Virginia State Legislature introduced House Bill No. 1958, a bill regarding school breakfast availability to all students.  This bill would enable all schools to participate in the School Breakfast Program without having to meet certain eligibility criteria for federal funding, thus increasing the overall number of children statewide who could receive breakfast at school in addition to lunch.

Being from rural Virginia and now caring for patients from Virginia, I feel a special obligation to support this bill and encourage other pediatricians to support access to free breakfast for all students. Food insecurity and inconsistent nutrition have not only been shown to negatively impact growth and development but also impact behavioral and mental health, as well as increasing risk of chronic disease in the future. By ensuring that all students have a reliable source of nutrition through school breakfast and lunch each day, we are one step closer to closing the food insecurity gap by creating equitable opportunities for all of our patients. While the bill did not pass this year, I urge Virginia legislators to reintroduce this bill again next year, because without policy changes, the ever-growing challenges of food insecurity in the pediatric population will persist.