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Strong Foundations: Getting it Right in the First 1000 Days

  • The ‘first thousand days’ refers to the period of development from conception to age 2. While early years experts have long been aware that this is an important period of development, researchers have only recently started to unlock some of the mysteries surrounding the processes by which genes, experiences and environments interact to influence development. New knowledge that has been unveiled has served to increase experts’ views of the significance of the first thousand days, and of the urgent need to reform our policies, practices and systems in response to the evidence.  

    The project

    Strong Foundations: Getting it Right in the First 1000 Days is a collaboration between the Centre for Community Child Health at the Murdoch Children’s Research Institute (MCRI); the Australian Research Alliance for Children and Youth (ARACY); Bupa Australia; the Bupa Health Foundation and PwC Australia.

    Key objectives of Strong Foundations

    • To raise awareness amongst government, policymakers and the public about the importance of the first 1000 days.
    • To ensure decisions that affect children and families are based on the best available evidence.
    • To ensure all steps that can be taken to improve early life for Australian children are identified and implemented as soon as possible. 

    As experts in research and evidence synthesis, one of CCCH’s key roles in the initiative was to develop a First Thousand Days Evidence Paper, synthesising current Australian and international evidence on the biological, social, global, and environmental influences on development. 

    A Case for Investment

    The strong foundations collaboration has published a report which showcases the economic benefits to society of investing in the first 1000 days. 

    The First 1000 Days: A Case for Investment uses economic modelling to illustrate the potential benefits to society of improving outcomes for children during the first 1000 days. 

    The report looked at the impacts of antenatal care and home ownership on the first 1000 days, using smoking during pregnancy and housing stability as the measures. The report revealed that if every child in Australia grew up in a stable housing situation, the potential annual benefit to Australia would be an estimated $3 billion.  

    The Evidence Paper

    The Strong Foundations project commenced with the compilation of an Evidence Paper which provides a comprehensive summary of the evidence for the significance of the first 1000 days. In an exhaustive look a the latest science from numerous disciplines, the Evidence Paper examines the impact of early experiences on all aspects of development and functioning, including health and wellbeing, mental health, social functioning, and cognitive development.

    The First Thousand Days: An Evidence Paper revealed that there are multiple influences on children’s development, starting from pre-conception, and at the level of the individual child, the family, the community, and broader society.

    Key findings

    • The age, health and wellbeing of both mother and father prior to the child’s conception affect the integrity of the embryo right from the very beginning.

    • The foetus uses cues provided by their mother’s physical and mental states to ‘predict’ the kind of world they will be born into, and adapts accordingly. This adaptation can be either beneficial or detrimental, depending on the child’s relationships and environments.

    • The human brain and our bodily systems – including the immune, gastrointestinal, and cardiovascular systems – operate as an integrated system, not as separate systems. This means that what happens in the first thousand days affects the whole body, with potentially profound consequences over the life course.

    • Disadvantage can be passed down through the generations at a cellular levelOur biology changes in response to stress, poverty and other prolonged adverse experiences, and these changes can be passed on to children from their parents and grandparents.

    • When children do not feel safe, calm or protected, the child’s brain places an emphasis on developing neuronal pathways that are associated with survival, before those that are essential to future learning and growth.

    • In addition to loving caregivers, children need safe communities, secure housing, access to green parklands, environments free from toxins, and access to affordable, nutritious foods. Many of these needs are beyond the control of individual families. This means that children can only develop as well as their families and their community and our broader society enable them to.

    • Not all changes that occur within the first thousand days are permanent. But as children grow, their ability to alter and change to make up for negative experiences and environments in the first thousand days becomes more difficult.

    Key documents

    Related resources

    Policy Brief: The First One Thousand Days – Our Greatest Opportunity, March 2018

    Presentation: What affects child development during the first 1000 days? Dr Tim Moore, February 2018, Royal Children's Hospital Grand Rounds

    Presentation: Factors affecting development during the first 1000 days – Evidence and implications Dr Tim Moore, March 2018, University of Otago, Wellington NZ



    *Select image to enlarge.

    Media highlights

    The first 1000 days  ABC Health Report, 13 May 2019

    The first thousand days – ABC Health Report, 9 October 2017

    First 1000 days crucial to child development: report – SBS News, 25 September 2017

    First thousand days of child’s life the most important for development – Herald Sun, 25 September 2017

    Study reveals what parents should do to give kids best start in life – Ten Eyewitness News, 25 September 2017

    New research: unborn babies 'predict' the world they will live in – Bupa, 25 September 2017

    Nutrition one of most 'significant individual factors' for child development in first 1,000 days: Comprehensive evidence paper – Food Navigator-Asia, 25 September 2017

    Dr Tim Moore on child development research – The Australian Science Media Centre, 25 September 2017

    Research shows the first 1000 days crucial to child’s development – Mums Grapevine, 26 September 2017

    Baby’s first 1000 days key to lifetime of happiness, doctors say – Channel 7 News, 26 September 2017

    MCRI Media Release – Head start is best for first thousand days, 25 September 2017 

    What can we do?

    The latest evidence on the first thousand days has implications for the way we support couples and families prior to conception, during the pregnancy period, and post-birth; and the way we support couples and families has implications for Australia’s future. 

    In considering how we might best address the wide range of possible interventions, we can consider four possible courses of action:

    1. Let natural selection sort the problem out. This is unlikely to be a viable solution, particularly in the short-term.
    2. Invest more in biomedical research and treatment. Research will continue to make in-roads, but this is a longer-term solution
    3. Educate and empower the public. This includes providing information, but also enabling the public to act on that information. This should be considered a priority.
    4. Change the environment. This involves efforts to improve the conditions under which families are raising young children. This should also be considered a priority. 

    CCCH, along with its collaborating organisations and other key stakeholders, intends to unpack the implications of the Evidence Paper for policy, practice and public health reform. Our first aim is to hold a Policy Roundtable to look at the implications of the evidence for policy, and determine how policy can best reform in line with the evidence.  


    For further information on the Strong Foundations initiative and the First Thousand Days: An Evidence Paper report, please contact Sue West,

    Keep informed

    To stay in touch with our progress on the Strong Foundations initiative, sign up to our Children’s Health and Development newsletter or follow CCCH on Twitter


Murdoch Childrens Research Institute

The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.