The First 1000 Days - important new research into child development

The new research paper, part funded by the Bupa Health Foundation, has highlighted how the health and wellbeing of a mother and child in the first thousand days of development can have long term consequences.

The study found that a foetus responds to its environment, using cues from its mother’s physical and emotional state to ‘predict’ the kind of world it will be born into – and its physical makeup changes accordingly.

It's not just the health of a baby’s mother that's important – the father’s health is important too.

Things like violent relationships, exposure to extreme stress, healthy food choices, household and environmental chemicals and time in the great outdoors can all physically impact the way a foetus develops – positively or negatively.

The First 1000 Days’ evidence paper was produced by the Centre for Community Child Health, Murdoch Children’s Research Institute (MCRI), part funded by the Bupa Health Foundation. Its aim is to raise awareness of how this critical time in a child’s development, from conception until two years old, can impact their long-term health.

It has highlighted a need for parents and soon-to-be parents to have greater access to information to empower them and help them make the best choices possible. It has also identified a need for greater education for policy makers and the general population.

Here’s a summary of some of the report’s highlights, and some tips to help parents and soon-to-be parents give their children the very best start to life.

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Stress

Sustained toxic stress during pregnancy has been found to affect a foetus’s nervous system and impact growth and length of gestation. Toxic stress is different to the stress most people experience in day-to-day life and can be caused by things like family violence, war, or long term financial troubles.

Lead author Dr Tim Moore says if a mother is exposed to extreme sustained stress during pregnancy, the baby is more likely to be hypervigilant, in other words, always looking out for danger.

“These babies are likely to be hard to settle and easily overreact. While that might help keep them safe initially in a dangerous environment, when they get to school, the ability to settle and maintain attention and focus, aren’t helped.”

There appears to be no need to worry about mild levels of stress and stress which the body may be placed under, because these may in fact be good for a developing foetus.

“You don’t actually want to cottonwool a parent during pregnancy and protect them from all normal stresses,” says Dr Moore. “Normal levels of stress are healthy for you and can actually help prepare a foetus for what they’re likely to experience in the real world.”

It’s highlighted a need for greater support systems for families experiencing domestic violence, financial stress or living in poor housing environments.

Family structure

Despite families becoming increasingly diverse in their structure, any concerns about the possible impact this structure may have on a child’s development has been proven to be unfounded.

Dr Moore says the research clearly shows it’s the quality of the parenting; the relationship between the parents and the bond between parents and their infant that has the biggest impact on the child – not the structure of the family.

“In the case of same sex parents, it’s not the sex of the parents, but the quality of the relationship between the parents that matters and the ability of them to care appropriately for the children.”

“It turns out that having two fathers or having two mothers doesn’t result in, well, anything," says Dr Moore.

“It just comes down to this issue of the relationship. What’s damaging for children is seeing their parents fighting, particularly if those things are unresolved, being neglected by their parents, being abused by their parents or others, or living in unsafe environments. Also receiving inadequate nutrition or inadequate stimulation and so on,” he says.

Nutrition

There’s clear evidence that nutrition during pregnancy, and in the first 1000 days of life, impacts a person’s long-term health.

Good nutrition reduces a child’s risk of later developing coronary heart disease, osteoporosis, asthma, type-2 diabetes, some forms of cancer, and lung disease.

A woman’s food choices during pregnancy can also later impact a child’s mental health, their food preferences, appetite, muscles, and insulin resistance.

If a pregnant woman is overweight or obese, it increases the risk of a difficult delivery, birth defects, haemorrhage and stillbirth.

There’s also an increasing body of evidence that shows paternal weight plays an important role, too, before conception.

After birth, research has found the longer a baby breastfeeds, the lower their chance of developing obesity later in life, with the risk dropping four percent per month for the first nine months. Breastfeeding has also been linked to reduced allergy rates.

Bonding with your baby

Once a baby is born, important connections in the brain are strengthened and reinforced through interactions with his or her primary care-giver.

Children will interact through facial expressions, babbling, gestures and later words, and adults who are responsive with similar gestures or sounds help to develop those connections in the brain.

But, if the person closest to the baby consistently doesn’t respond or is unreliable, absent or under-stimulating in their response, it can negatively impact the child’s development, behaviour, learning and health outcomes, later in life.

“Babies certainly need to feel safe and secure,” says Dr Moore.

“They come out of the world hard wired to find the person who can provide that. They look for the face that goes with the voice that they’ve been hearing in the womb for the last few months of pregnancy and they are attracted to that face more than they are to other faces. So, there are biological processes here which are gearing them up to attach,” he says.

When they don’t feel calm, protected and safe, a child’s brain is more likely to develop neuronal pathways which are associated with survival, rather than those which are needed for learning and growth.

Read about some baby bonding ideas here.

Allergies

Australia has one of the highest rates of allergies in the world, with the youngest generation the worst affected. Researchers have gone so far as to describe it as an epidemic.

The good news is pregnant women and soon-to-be parents may be able to help prevent the development of allergies, with the first thousand days being a critical period for immune development.

The gut is now known to be an immune organ, home to the largest immune network in the whole body.

In the days after a baby is born, there’s a huge influx of bacteria in a baby’s gut which stimulates the immune system, which helps the body fight infection.

“There is evidence that we are trying to keep ourselves too clean, and what we have to realise about bacteria is that bacteria live in us and on us, and have co-evolved with us, and shape our wellbeing in ways that we are only just now discovering,” says Dr Moore.

Research indicates children who develop allergic diseases tend to have less diversity in the number of bacteria in their gut when they’re babies. They tended to have less ‘friendly’ bacteria, and more of the disease producing bacteria. In other words – exposure to everyday ‘friendly’ germs during the very early stages of life isn’t something to be afraid of, it may in fact help to prevent allergies.

Research has also found that babies who are fed breast milk have a lower likelihood of developing allergies later.

Exclusive breastfeeding is recommended where possible until a baby is around 6 months, when other baby-appropriate food can be introduced. If these extra foods are introduced too early (before 4 months) or aren’t given safely, it can significantly restrict or even stunt a child’s growth, according to the research paper.

Childhood obesity

Childhood obesity is reaching what’s being described as epidemic proportions. Researchers say there’s a link between babies who put on excessive weight and obesity in later life.

Some of the key ways parents can potentially help to prevent their child developing obesity later in life include:

• Quitting smoking before conception
• Maintaining a healthy weight during pregnancy
• The father maintaining a healthy weight prior to conception
• Maintaining healthy blood sugar levels during pregnancy
• At least 12 hours sleep a day for babies
• Exclusive breastfeeding up to six months where possible.

Exposure to chemicals and environmental toxins 

During the first 1000 days, humans are particularly vulnerable to the effects of toxic chemicals. Researchers studying the umbilical cords of newborn babies found, on average 200 industrial chemicals. What this tells us is that when a mother is exposed to chemicals in food, water, air, and other products, these toxins are shared with her foetus.

Exposure to some chemicals during pregnancy has been linked to preterm birth, and a range of other health outcomes.

Alcohol and child development

Exposure to alcohol during pregnancy is the most preventable cause of birth defect. It has also been found to be the number one cause of cognitive impairment and neurodevelopmental disorders. A 2013 National Drug Strategy Household Survey found one in four women continued to drink alcohol even once they knew they were pregnant.

The research paper highlighted the array of problems which drinking alcohol during pregnancy can cause, including:

• Abnormalities of the formation of the face
• Intellectual and learning disabilities
• Memory problems
• Speech and language delays
• Behavioural problems
• Social difficulties.

While people often ask if there could be a ‘safe’ level of drinking during pregnancy – this is something which hasn’t been proven, so it’s recommended women don’t drink at all during this time.

Smoking while pregnant

Smoking can negatively impact fertility, and smoking during pregnancy has a serious long-term impact on a child’s health. Nicotine can cause blood vessels to narrow, which can impact the supply of blood, oxygen and nutrients to the foetus.

There’s now a growing body of evidence smoking can also impact the development of an unborn baby’s brain, impact the risk of it being stillborn, and increase the risk of sudden infant death syndrome (SIDS). Smoking also increases the risk of placental abruption and placenta praevia.

Breast milk production has been found to be lower in smokers, and exposing children to second hand smoke has been found to impact lung development, and increase the risk of asthma, middle ear disease and respiratory disease.

While the first thousand days are a critical time in a child’s development and long-term health, all is not lost if someone hasn’t had the best start to life.

“It’s not the end of the world, it just becomes harder to change. We don’t want parents to feel like ‘what have I done’, it’s about encouraging everyone to think about the importance of this time period, and how the whole of society should consider this responsibility,” says Dr Moore.

“Investing in healthy children is an investment in the future. If you’ve got a good start in life, you’ve got a great chance in having a longer, healthier, happier life,” says Annette Schmiede, Executive Leader of the Bupa Health Foundation.

You can find some great information, respources, tools and stories to help guide you through your first thousand days here.

First 1000 Days research paper media coverage:

Herald Sun: First thousand days of child's life most important for development

Channel 10: Study reveals what parents should do to give their children the best start in life

SBS: First 1000 days crucial to child development: report

AAP: First 1000 days crucial to development