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First 1,000 days of life crucial to a child’s future

As the government prepares to publish a major study on early years care in France, renowned paediatrician Arnault Pfersdorff explains that parents’ time is vital to the healthy development of a young child

The first 1,000 days of life, starting in the womb and lasting to around two years old, are vital to the future development of every child.

The concept is considered so important – in both developing and developed nations – that Unicef has launched a child development protocol based on it.

It covers everything from poor access to food and healthcare to fears that young children in developed nations are missing out on vital elements that could damage their development into healthy, stable, happy adults. The overuse of screens is one predominant factor.

The French government will soon release the results of a study by a commission of 18 experts into how best to improve the chances of young children at this vital stage.

They have examined maternity and paternity leave, childcare for working parents, access to medical and social care and support for young parents.The “first 1,000 days” – originally referred to in research published in The Lancet in 2016 – start from about the fourth month of pregnancy.

A baby is growing at a faster rate than at any other time and the connections in the brain are established at a frequency of 200,000 a minute.
Highly-regarded paediatrician Arnault Pfersdorff said understanding of the importance of this stage in life is fairly recent. “Neuroscientists have discovered a foetus not only feels emotions, but reacts to them,” he said.

“We have seen that there are chem-ical reactions and secretion of hormones in the foetus depending on the level of stress of the mother, the way in which the two parents speak to each other, etc.

“A child needs the right hormones in place to develop well. We used to say the first years were important from seven years old, the age of reason, and fathers often only used to get interested after the child reached that age.

“Now we know the majority of the fundamental processes which will determine the life of someone start in the first 1,000 days.”

One factor the French commission is examining is how to give parents more support. Studies have shown that more than half say it is difficult to be a parent and 93% say they have had some problems in feeding their child up to the age of three years.

Dr Pfersdorff, an expert on the France 5 TV Maison des Maternelles programme, agreed that parents are often not prepared for harder times after the euphoria of the birth: “After a month, the parents are tired. The father goes back to work. Later, the mother. They have questions.

“They look on the internet, but there are no real answers. This is the stage when the parents start getting lost.

“When I do the first check-up on a newborn in hospital, I try to tell the parents what to expect, because they really do not know.

“We think parenting is an innate talent but it isn’t. I think there needs to be more training to help them.”

He said the biggest issue affecting children in the west today is a lack of time: “We have to dress children hurriedly in the morning to get them into the car because one needs to be dropped off at crèche and the other at school, and we can’t be late for work.

“Mornings are rushed and the only time a family is all together is in the evening, but then everyone is tired.

“The first thing I say to young parents is ‘give time’. Not just spend time with them. Turn off the television, the phone, the discussion with someone else, and spend time with the child.”

He said changing the pattern of rushed mornings before work would need a big change in society, but he thinks it is necessary.

“Children are the first to lose out because parents calm them down by giving them a phone or an iPad to look at, even at a young age.

“I see this sometimes in my surgery. It is a catastrophe. Neuroscience has shown us that the impact of screens on the retina will block the production of the hormone melatonin, which regulates sleep. If a child’s level of melatonin is not sufficient, his sleep will be disturbed and next morning he will be unreceptive and aggressive.”

He says one answer would be to introduce much longer paid maternity and paternity leave. In France, women have the right to six weeks before the birth and 10 weeks afterwards, and men have 14 days. Dr Pfersdorff, who has 30 years’ experience in paediatrics, said: “There are countries which have found solutions, such as Norway, where it lasts a year.

“When a couple come to my surgery with a 15-day-old baby and the mother says she has decided to take a year’s sabbatical, even though it will be difficult financially, all I can do is encourage them.

“It is essential that the child has the time to be reassured by the parents’ presence, their touch, their smell, the massages they will give him, the walks they will take with them without the pressure of time. It will make a difference to their whole life.

“The father needs more time –14 days is nothing. It is better he takes it after the first month, when he can do very little to get involved as the baby sleeps a lot and breastfeeds.

“At one month, problems can start with colic and lack of sleep and now the father can really help by taking the baby in his arms. Parents do not know that. When I see a young couple, I like to see them both and explain.”

He said there needs to be more support so that more women breastfeed for longer. In France, society still does not accept that this also gives the baby the best start in life: “We health workers must repeat the message that breast milk is the only 100% free natural medication.

“All studies show it is best. The big milk companies earn a great deal of money from baby milk and give free samples at hospital.

“You still need a great deal of determination to keep breastfeeding. I am not saying all parents bring up their children badly. No. But many would appreciate more support.”

Dr Pfersdorff has recently written a book 140 Jeux d’éveil pour Préparer son Enfant à la Maternelle, in French only, published by Hatier, which gives ideas for simple games to play at home with a child up to three years to develop language, motor functions, social skills and self-confidence.

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