Your first 1000 days shape the rest of your life
The basis of lifelong health, wellbeing and productivity are laid down during the first 1 000 days of our lives. In that surprisingly short period — the 1 000 days from conception to age two (including 270 days in pregnancy), our environment activates our genetic potential in ways that determine our lifelong learning, earning and happiness.
The nutrition the foetus absorbs in the womb, the stress hormones that jolt it, and the emotional tone of the mother’s voice, among other experiences, initiate our phenotypical development — how our genetic potential is expressed. The type and process of birthing, close contact with the mother’s skin, breastfeeding, and emotional nurturance, protection and stimulation provided by the family, continue these gestational processes beyond birth.
These early experiences not only shape the structure of our developing organs and our physiological pathways, but they also create templates for how we process experiences in the future. For example, if during pregnancy a foetus does not receive the nutrition it requires, its biological systems adapt to store nutrients to safeguard against future deprivation. This explains what at first seems to be the paradoxical link between being born small and the tendency to become overweight and develop diabetes and cardiovascular disease in adulthood.
Similar processes are triggered with respect to emotional reactions, which are also primed by early events. When we experience stress and fear, cortisol helps us cope by readying us for fight or flight. It’s important though, that once the fear or stress is over, cortisol levels returns to normal. During pregnancy and infancy, the developing child’s homeostatic mechanisms are still being established. If babies are exposed to high levels of enduring (or what is called toxic) stress, as might occur if their mother is under threat or if young children are neglected or abused, they become primed to expect more stress. Their cortisol levels stay high and their stress responses are galvanised by even low levels of threat. This puts them at risk of developing a range of physical, mental and social health problems as they go through adolescence and into adulthood.
What we know about how these early epigenetic and developmental mechanisms work, and what their implications are for improving health and wellbeing, is explored in a new global health series in the Lancet, called Advancing Early Child Development: From Science to Scale. The series’ launch in early October in Washington DC was linked to a flagship event at the World Bank-IMF annual meeting of finance ministers, the Human Capital Summit on investing in the early years for growth and productivity.
Discussions about improving
socioeconomic development at the highest levels take these early child development processes very seriously. For individuals, a poor start in life can cut their potential adult earnings by as much as a quarter. With some 43% of children younger than five years of age in low- and middle-income countries at risk of poor early development, the potential loss to highly affected countries can run into billions. We estimate that educational underachievement in South Africa that is attributable to poor early infant growth reduces potential future earnings by about 1.3% of gross domestic product (GDP) or R62-billion a year. Some countries such as India and Pakistan lose more as a proportion of GDP in anticipated adult earnings to poor child growth than they currently spend on health.
So what can be done about it? The Lancet series explores approaches to promote early child development at a number of levels. Government recognition of the importance of early child development finds expression in a range of policies that support families to care for young children. Parental leave, guaranteed financial security through a minimum wage or social assistance, and free or subsidised mother and child health services all help to prevent families falling into dire poverty and becoming victims of the kind of stress and hardship that threatens the healthy growth and wellbeing of young children. Other important factors are ensurand
ing that children are planned and wanted and are born at expected birth weight and at term. Exclusive breastfeeding gives newborns the best start in life, promotes their health and is associated with increased intelligence in adulthood. Nutritious weaning food and protection from contaminants is critical to preventing a vicious cycle of infection and diarrhoea that erodes young children’s health, growth and ability to explore and learn about their world.
Most important of all to the development of young children, and operating in every second of their life, is the devotion and protection they elicit from their parents and families. The unbridled love we feel towards our young child is built into our human nature. Big eyes in a round face and babies’ signals of distress and delight, among other things, draw us into a relationship and commitment that sees us enabling and anticipating their needs and opening their opportunities for the future. It is this nurturing care that gives a child singular benefits well into adulthood. The South African launch of the Lancet series, linked to the DST Science Forum South Africa, took place on December 7 at the CSIR International Conference Centre in Pretoria. The Minster of Science and Technology, Naledi Pandor, presented the keynote. The series can be found at: www.thelancet.com/series/ECD2016