Change the world in 1,000 days: It starts with supporting babies and their families




For the Recorder

Published: 03-08-2024 10:20 AM

A recent essay by Blythe Thomas, initiative director at 1000 Days, an organization that fights “to make health and well-being during the first 1,000 days (between pregnancy and a child’s 2nd birthday) a policy and funding priority,” begins by asking “If you had 1,000 days to change the world, how would you do it?”

It’s a provocative and crucial question. I have a particular interest in focusing on the question as it impacts children and their education. What can we do in a thousand days that might help all our children to come to school ready and able to learn? Investing in our children is investing in their future and in ours, and as Maria von Trapp advised in “The Sound of Music,” starting at their very beginning, those first 1,000 days, is a very good place to start.

What is it about those first 1,000 days that are so significant?

The first 1,000 days, from conception to around the 2nd birthday, is the time during which the foundation for a person’s lifelong health, well-being, learning and productivity is laid. A developing fetus needs a healthy mother who is getting good nutrition, is living relatively stress free, avoids toxins, both internal (smoking, drugs or alcohol) and environmental (air and water pollution, lead in pipes and paint, guns and violence), and has access to regular medical care and consultation. Once born, babies continue to need good nutrition and significant interaction with their primary caregivers. As they respond to these interactions they are forming billions and billions of neural connections as their brains form and develop. It is essential that there is significant time for the parents (particularly the mother) to interact with the child, to spend time with them, bond with them, so that they can safely explore their environment, and that they are living in as stable, safe, and stress-free environment as possible.

Informed both by research on the crucial importance of those first 1,000 days and by their decision to place the health and well-being of their population as their number one priority, many of the world’s countries have adopted policies that offer medical, nutritional, financial, and social support to young families from the very start. They have decided that helping newborns and their families to focus on their new lives together without having to worry about medical bills, mortgage payments, or other stressors will lead to better health and the best chance for a healthy, happy, and successful future for the child. These policies have had very positive results, with many of the countries now identified as the best places in the world to raise a family, as having top-rated school systems, and having increasingly healthy populations. I want to share a few of those policies that have made such a powerful difference for their children and families.

Paid family leave

There is nothing more important than paid family leave when we consider ways to better support families that are pregnant and/or living with an infant. The idea behind paid family leave is that a woman who is pregnant needs to minimize her own stress and maximize her health, and working full time leading up to the birth and then returning to work shortly after birth does the opposite.

There is not one way to offer paid family leave. Greece and Germany both offer several weeks of paid leave before birth and then roughly the same number of weeks of paid family leave after the birth. Sweden, which tops the list of best places to give birth and raise a family, offers 420 days of paid family leave, which can all go to the mother, or be split between the mother and father however the family chooses. Estonia offers more than a year and a half of paid leave to new parents. Bulgaria, Hungary, Japan, Lithuania, Austria, Slovakia, Latvia, Norway and Slovenia offer over a year’s worth of paid leave as well. In fact, there are only seven countries in the United Nations that do not offer paid family leave: six small countries and the United States, the only wealthy country that does not do so.

Universal health care

Most of the countries of the Organization for Economic Development nations (OECD) have some form of universal health care for their populations. They do not all look exactly the same, but all offer basic health care to citizens in the country at no cost. While it is possible to purchase private insurance in most of these countries, people’s basic health care needs can be addressed for free, and in many of these countries that includes giving birth.

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In Sweden, for examples, it costs virtually nothing for Swedish women to give birth. In the U.S., since there is no universal health care, giving birth can be very expensive, especially if the delivery is at all complicated, with prices ranging from $15,000 to $30,000, depending on insurance. There is also a greater risk that there will be health consequences, especially for families that are cutting medical corners because they can’t afford to get the care they need. The rate of women who die in childbirth is significantly higher in poorer communities as is the rate of infant deaths. Having the government provide basic health care coverage, including medical coverage during pregnancy, birth, and beyond can literally be the difference between life and death. Universal health allows women to get regular checkups throughout pregnancy, a fully covered birthing experience, and ongoing postpartum care at no cost. Universal health care, combined with paid family leave means that families can focus on their baby and their family without the stress of looming hospital bills or worries about missing paychecks.


Most families in the OECD and European Union nations pay a relatively low percentage of their incomes for childcare. Swedish families, for example, pay around 5 % of their income for childcare; Japanese families 7%, French families 8%, and Canadian families around 18%. This is possible largely because their governments pay the rest of the actual cost of the care.

On average, families in the U.S. pay more than 30% of their incomes on childcare if they can find an opening in a childcare center near them. As we found out during COVID, available and affordable childcare is essential if families are to function in the working world, and if the economy is going to function, as more families cannot afford to have an adult staying at home. Many women (who do most of the childcare) had to leave their jobs or severely cut back their hours when schools closed during the pandemic, and that had a significant impact on the overall economy.

Childcare seats are limited, partially because, despite the significant price tag, wages for childcare workers are at poverty level, with few or no benefits. The wages are not enough for them to support their own families, and so it has been increasingly difficult to find people to work at childcare centers and to stay. It also means that many of those who are hired may not have had (and do not receive) adequate education regarding their work with children, due to the constant turnover. Without significant government support for public childcare there are many childcare deserts — places where there are not enough seats for families needing childcare help — and it is estimated that a lack of childcare availability costs the U.S. more than $122-billion a year in lost productivity.


Most of our peer countries in the world have chosen to invest in their people and their investments have paid off with better health, schools and economies. The rich nations of the OECD and European Union each contribute an average of $14,000 per year in support of each toddler. Despite its great wealth, the U.S. only contributes around $500 per toddler.

Sarah Carr, a contributing editor to the Hechinger Report, writes, “Unlike most developed nations, America has never treated care of its youngest children as a public good worthy of significant public investment, especially in relation to K-12 public education.” It has chosen to invest most heavily in its military, in cutting taxes for its wealthiest individuals and corporations, and in allowing those corporations that are taxed to move their money offshore, beyond the reach of the public, depriving us of badly needed public dollars that could be used to support our children, our families and our schools. We can continue to support our growing inequality at the cost of our health and well-being, or we can invest more in our people.

Getting our children off to the best start possible is clearly to the benefit of the children and their families, but it is also of great benefit to the country. I can’t think of a better way to change the world than by investing as fully as possible in the first 1,000 days of our children’s lives, from conception to their 2nd  birthday, so that they have every chance to live happy, healthy and successful lives.

Doug Selwyn taught at K-12 public schools from 1985 until 2000 and then at university as a professor of education until he retired in 2017. He is the chair of the Franklin County Continuing the Political Revolution education task force. You can reach him at