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The First Thousand Days: early, integrated and evidence-based approaches to improving child health: coming to a population near you?
  1. Jonathan C Darling1,
  2. Panagiotis D Bamidis2,3,
  3. Janice Burberry4,
  4. Mary C J Rudolf5
  1. 1 Division of Women's and Children's Health, University of Leeds School of Medicine, Leeds, West Yorkshire, UK
  2. 2 Leeds Institute of Medical Education, University of Leeds School of Medicine, Leeds, West Yorkshire, UK
  3. 3 School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  4. 4 Public Health (Children and Families) Adults and Health Directorate, Leeds City Council, Leeds, UK
  5. 5 Department of Population Health, Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
  1. Correspondence to Dr Jonathan C Darling, Division of Women's and Children's Health, University of Leeds School of Medicine, Leeds, West Yorkshire LS2 9JT, UK; J.C.Darling{at}


The ‘First Thousand Days’ refers to the period from conception to the child’s second birthday. It is increasingly gaining traction as a concept to guide public health policy. It is seen as a crucial window of opportunity for interventions that improve child and population health. This review outlines the origin and growth of the First Thousand Days concept, and the evidence behind it, particularly in the areas of brain development and cognition; mental and emotional health; nutrition and obesity; programming and economic benefits. The review then describes UK experience of use of the concept to inform policy, and a recent government inquiry that mandates more widespread implementation.

  • comm child health
  • health economics
  • general paediatrics

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  • Correction notice This paper has been amended since it was published online. There is a factual error regarding the funding of the A Better Start programme. This sentence: ‘A Better Start’ is a 10-year, £215 million programme by the National Children’s Bureau, funded by the National Lottery' has been changed to ‘A Better Start’ is a 10-year, £215 million programme, funded by the National Lottery.'

  • Contributors JD wrote the first draft of the manuscript, drawing on documents written for Leeds City Council by JB. PDB, JB and MCJR all contributed to the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement No data are available. Not applicable.