‘What happens in a child’s first 1,000 days affects the rest of life’

Through a microscope, an intern in the IVF department of the VU University Medical Center sees a sperm cell fertilizing an egg. The beginning of a new human life. ‘A powerful moment that would continue to fascinate me for the rest of my life’, she calls it.

The fascination remained and that student, Tessa Roseboom, is now professor of Early Development and Health. Her research repeatedly confirms how important the first thousand days of a person’s life are. That period, from conception to roughly the second birthday, determines much more than just the health of the child: for example, the start of a human life has direct consequences on the opportunities it will have on the labor market, for example.

Investing in the first days of life can therefore have enormous social consequences, says Roseboom. In her new book, Right off to a good startshe describes the world to be won and how we can achieve it.

What happens during the first thousand days of a child, that can mark that period so strongly on life?

‘It is a period of extraordinary growth: from a single fertilized egg to a toddler in two years. At no other time in life does a person grow so fast, it lays the foundation for the rest of life. This is how you can after birth almost no more new heart muscle cells are producedso a person has to make do with what was built during pregnancy.

‘If something breaks down in that phase of life, be it physical or psychological, it can have consequences for the rest of life. Animal studies show that bad experiences can even last for generations. In a American research mice received shocks when they noticed a certain smell. Even their grandchildren shied away from that smell, never having experienced a shock. This is about mice, but there are also indications that human trauma is inherited.’

According to you, all ‘false starts’ add up to a social problem. That sounds logical, but how do you prove that?

‘I have been researching Hunger Winter Babies for years myself. We see that children born during that exceptional period were not only less healthy, but also had smaller brains. They were less able to participate in the labor market later in life, because their mothers had fewer building blocks during pregnancy to pass on to their child via the placenta. ‘You are what your mother eats’, we sometimes say.

‘From research in New Zealand and Denmark turns out that most of the social costs there, for example for care, benefits and justice, are incurred by a small part of society. 20 percent of society accounts for 80 percent of the social costs, to be exact. What does that 20 percent have in common? They all got off to a false start.

‘The other way around there is also research made as a result of investment in early childhood development. Nobel laureate James Heckman saw that if families with a tight budget and a child on the way received good childcare and medical care, for example, the children grew up healthier and had better chances in life. Very logical, but the most important finding was that the earlier the investment was made in the development, the greater the return.’

‘Investing in a good start’ is not easy. Suppose you are the first Dutch Minister of Early Development, which plans do you give the highest priority?

‘Firstly, the full reimbursement for contraception, to prevent any unwanted pregnancy. We still see that there are people who for financial reasons give up contraceptives.

‘It is also crucial that if people want to become pregnant, they can do so as healthily as possible. The greatest benefit can be achieved by offering help to quit smoking.

‘Then I would also fully reimburse and extend paternity leave, or parental leave in general. Paternity leave is currently partly reimbursed, but there are still families who cannot afford to do without that other income. As a result, they have to miss precious time with their new child. That has to change: that love is very valuable and pays off again.’

What can parents do to give their child the best start?

‘First of all, take a good look at life before they have a child. Mental and physical health, safety and a strong relationship all contribute. At the same time, it is important that we as a society rid parenting of a number of persistent taboos. We see that parents are often hesitant to ask for help, but it takes a village to raise a child† I would advise couples who want to have children to talk to each other about who they can ask for help during the difficult moments that the arrival of a child inevitably entails.’

Your book also states that, according to UNICEF, Dutch children invariably happiest in the world to be. So here it usually goes well with those first thousand days?

‘Relatively speaking, things are going very well in the Netherlands. But the Netherlands still has inequality: it matters where your cradle is. This is true on a national scale, but also within cities. I find it indigestible that the chance of surviving your birth twice bigger is if you are born in Amsterdam Center, then in Southeast. On the Dutch Opportunity card it can also be seen that the place of birth influences the school recommendation: born in Tiel? Then your chance of getting a HAVO recommendation or higher is almost half as small as if you were born in Heemstede.’

The plea to invest more in a good start has been heard for some time. Is there any progress in the case?

‘Certainly. There are initiatives worldwide. Particularly in Africa and Asia, a movement has emerged, supported by NGOs from the United States, to show the importance of the first thousand days especially in areas of poverty and malnutrition.

‘In the Netherlands we have had the national program since 2018 Promising Start, in which politics, care and science come together to help underprivileged families. Another program is Ode aan Ouders, run by the Cooperating Health Funds, in which we want to break the taboos surrounding parenthood and provide further support. It is a task for everyone, with interests for everyone: from mothers and fathers to grandparents and neighbours.’