The first 1,000 days: Brains are built, not born
By Maxine Hayes, MD, MPH
The first 1,000 days, from birth to age 3, have the most pronounced impact on a person’s life-long health and well-being. I had the privilege of discussing strategies to make the most of these first 1,000 days when I visited Children’s Hospitals and Clinics of Minnesota in September.
Children born today face the prospect of growing up less healthy, living shorter lives and being less equipped to compete and lead in a world economy than previous generations. For the first time, we are expecting less of our children and letting them down. We should do better, and the good news is we can if we work together.
The opportunity resides in how we impact the first 1,000 days of every child’s life. We know more now than ever about brain science, which shows that by age 3, 80 percent of our brain is developed. We also know that:
- Brains are built (not born) over time – prenatally to young adulthood.
- Brain development is integrated. The areas underlying social, emotional and cognitive skills are connected and rely on each other.
- Toxic stress, in the form of poverty, poor nutrition, inadequate housing, exposure to violence and limited positive and nurturing behaviors, disrupts brain development and can have a lifelong effect on learning, behavior and health.
- Positive parenting and creating the right conditions can buffer toxic stress and build resilience.
Frederick Douglass once said, “It is easier to build strong children than to repair broken men.” This is a motivating principle behind many states’ efforts to bolster early child development through policy and practice. In the state of Washington, this is our mission. State leaders are using a collective impact1 initiative to provide a structure for cross-sector stakeholders, including state departments, foundations, social service agencies and pediatricians, to forge a common agenda around the shared vision that all children in Washington will thrive in safe, stable, nurturing relationships and environments, beginning with a focus primarily on the first 1,000 days.
It all begins with a conversation. That’s why the discussions convened by Children’s among pediatric clinicians and state leaders are so valuable. It sends a signal that pediatricians and primary care providers as well as policymakers have important roles to play in this work. By working together and focusing on our youngest at the most critical points in time, we can change the course of life and set our children on a path toward good health and academic success.
Maxine Hayes, MD, MPH, is clinical professor of pediatrics at the University of Washington School of Medicine.
1 Stanford social innovations review 2013, “How collective impact address complexity” — John Kania and Mark Kramer.