The First 1.000 Days of Children

The first 1.000 days of a child's life are critical to their health and well-being, both during that initial period and throughout the rest of their life. This is when the foundation is laid for physical, psychological and social development. The ‘1.000 days’ start before conception and continue until a child's second birthday. 

‘The First 1000 Days of Children’ dashboard

‘The First 1.000 Days of Children’ dashboard displays the health status of Utrecht's children and their families in figures during this period. It is also possible to view the neighbourhood figures. These dashboards give Utrecht professionals and other interested parties insight into which themes and neighbourhoods need additional effort. The dashboard is based on the latest available data from Utrecht's Youth Healthcare Services (JGZ), Perined, the National Institute for Public Health and the Environment (RIVM), the Key Register of Persons and the Municipality of Utrecht's population forecast. 

Dashboard update in 2025

The dashboard and its conclusion and recommendations were first published in 2024 and are updated annually. One new indicator was added to the dashboard in 2025: Parents of 0 to 2-year-olds who take medication for anxiety or depression. One indicator has been adjusted, as it was also adjusted in the national Promising Start Monitor: ‘pregnant women with mental or psychiatric problems’ has been changed to ‘pregnant women taking medication for anxiety or depression’. As the numbers show a similar picture to last year, the conclusion and recommendations have been left largely unchanged, except for an addition about maternity care. The similarity to last year is not surprising, as health trends typically change slowly over time. In addition, newer data was not available for all indicators. 

The number of young children has been declining but is expected to increase from 2027 

The number of 0 to 2-year-olds in Utrecht has declined over the past ten years, from around 14.300 to nearly 11.900 young children. In line with the national forecast, the number of young children aged 0 to 2 in Utrecht is expected to increase. In Zuidwest, the number of 0 to 2-year-olds will already begin to increase in 2026. This is expected to be the district with the highest number in that age group by 2039. In 2025, that title belongs to Leidsche Rijn.. 

4.316 children were born in Utrecht in 2024. According to the forecast, the number of births is expected to exceed 5.000 in 2031 and 6.000 in 2036.

4% of pregnant women take medication for anxiety or depression

4% of pregnant women in Utrecht took medication for anxiety or depression in 2022. This figure has been stable since 2017. Nationwide, the percentage of pregnant women taking medication for anxiety or depression has been around 4.5% for years.. In Utrecht, 7% of parents of 0 to 2-year-olds took medication for anxiety or depression in 2022. This is similar to the national average and has also been stable since 2017. In Zuidwest, this percentage is higher than average. 

75% of pregnant women begin pregnancy counselling before the tenth week of pregnancy 

Three-quarters of pregnant women started pregnancy counselling before the tenth week of pregnancy in 2021. Pregnancy counselling was less frequently started before the tenth week of pregnancy between 2019 and 2020. This did not decrease further in 2021. More recent data is not available. 

Stable percentage of children born prematurely or at low birth weight 

The percentage of children born prematurely or at a low birth weight in Utrecht has been stable at around 15% (Perined, 2021). This is lower than in other major cities and similar to the Dutch average.

The number of hours of maternity care per family declined significantly between 2022 and 2024 due to limited availability of maternity nurses 

Over the course of approximately 2.5 years, the average number of hours of maternity care per family in the Utrecht KSV (maternity care network) region declined from 40 hours in 2022 to around 33 hours by mid-2024.. This trend is also visible nationally (maternity care labour market exploration, 2025). Not all families receive the same amount of maternity care. The number of hours of maternity care is indicated by the maternity nurse and midwife, based on medical necessity, family situation and in consultation with the (expectant) parents. In neighbourhoods where more families are entitled to additional maternity care, the actual number of care hours tends to be lower. This is increasingly due to limited availability of maternity nurses. Not all maternity care providers operate in every postcode area, some parents register later, and the personal contribution for maternity care creates barriers. 

The minimum number of 24 hours of maternity care is increasingly not provided. 29% of all parents and expectant parents in the Utrecht KSV region received less than the minimum number of hours of maternity care in 2024. 

Information on the number of maternity care hours per family is not included in the dashboard because it is not structurally available. Information on the percentage of families receiving maternity care is available in the Promising Start Regional Outlook, but this information cannot be updated after 2022. As such, we did not include this information in the dashboard. 

Mothers stop exclusive breastfeeding relatively often during the three months after birth 

71% of children in Utrecht are exclusively breastfed after birth. At three months, forty-one percent are still exclusively breastfed. The percentage of children receiving a combination of breastfeeding and formula remains more or less stable between birth and three months (18% and 19%, respectively). The percentage of children exclusively receiving formula increases from 12% to 41% during this period. 

Children with migrant parents are more likely to be exposed to tobacco smoke at home 

6% of 0 to 2-year-olds are exposed to tobacco smoke at home. This number increases to 9% when their parents are migrants. Indoor smoking occurs more frequently in Overvecht (14%) and Zuidwest (8%) compared to other areas. 

In households where smoking occurs, infants and children face a higher risk of sudden infant death syndrome and are more likely to experience health problems..The toxins from tobacco smoke remain airborne for a long time and settle on clothes, floors, curtains, toys and furniture. Children are exposed to these substances while being highly sensitive to the toxins in smoke, as their lungs and immune systems are not yet fully developed. Children who grow up in households where smoking occurs are three times more likely to start smoking themselves later in life. 

Children from Overvecht and Zuidwest have a less promising start

Children from Overvecht and Zuidwest are more often born prematurely and/or at a low birth weight. They also face a relatively higher risk of death around the time of birth (10.4 per 1.000 births in Zuidwest and 8.7 per 1.000 in Overvecht (Perined, 2021)) and are more often raised in poverty (Statistics Netherlands, 2023). Young children in Overvecht, Zuidwest, and Leidsche Rijn are also more likely to experience developmental delays compared to children in other neighbourhoods in Utrecht (JGZ,2024).. 

Children of parents with primary or VMBO education have the greatest disparity 

Clear health disparities are already evident in children aged 0 to 2 according to their parents' educational attainment. Children of parents with primary or VMBO education have the greatest health disparity or risk thereof: 

• Their mothers are more likely to have smoked during pregnancy (JGZ, 2023)
• They tend to develop more slowly (JGZ, 2024)
• They are more often closely monitored by JGZ due to developmental risk factors (JGZ, 2022)
• They are more likely to be overweight (JGZ, 2023). 

Children whose parents have completed HAVO, VWO, or MBO education also face developmental disparities compared to those whose parents hold HBO or university degrees, though generally to a lesser extent. 

Developmental disparities among young children, linked to their parents’ educational background, have widened between 2015 and 2022

Between 2015 and 2022, developmental disparities have increased between children of parents with primary, VMBO, HAVO, VWO or MBO educational levels and those with parents educated at HBO or university level. Since 2022, the percentage of children with developmental delays has decreased among families with HAVO, VWO, or MBO educational backgrounds. This is a favourable development, but these children are still more likely to have developmental delays than before the pandemic (2020). Between 2023 and 2024, the percentage of children with developmental delays has decreased significantly among those whose parents’ level of education is primary school or VMBO. This makes the percentage similar to the period before the pandemic. The sustainability of this decline can only be assessed once the 2025 data is available.  

JGZ monitored more children closely due to developmental risk factors between 2016 and 2019 – update to come 

The percentage of children monitored closely by JGZ increased between 2016 and 2019. This was irrespective of the children's parents’ educational attainment. The percentage of children of parents with primary education or VMBO monitored closely decreased between 2019 and 2021. The percentage of children monitored closely continued to rise for children of parents with an HBO or university degree during the same period. The data for 2023 and 2024 will be available soon, at which point this conclusion will be updated. 

Six out of ten children with developmental risk factors have parents with an HBO or university degree

Despite the fact that children of parents with an HBO or university degree are less likely to be monitored closely, more than six in ten 0 to 2-year-olds monitored closely by JGZ have parents with an HBO or university degree (JGZ, 2022). This is because 80% of parents in Utrecht are highly educated. The accumulation of risk factors tends to be less complex in children of these parents than in those with another educational attainment, as they are often limited to a single domain (JGZ, 2021).

Health disparities increase as children age 

A major concern is that health disparities increase as children get older. We see differences in excess weight by parental educational attainment as early as age 2, and these widen further as children get older. This highlights the importance of investing in the first 1,000 days of children's lives. 

The first 1,000 days of a child's life are critical to their health and well-being, both during that initial period and throughout the rest of their life.. This means that the prevention of problems is vital. Based on the conclusion, the following recommendations were formulated for organisations contributing to a Promising Start: 

1. Prepare for the growing demand in care capacity for expectant parents and children aged 0 to 2, as this population is projected to increase.
2. In areas with more vulnerable families, maternity care hours must be raised to meet at least the statutory minimum.
3. Explore what is needed to (further) support breastfeeding in the first three months after birth, as the percentage of exclusively breastfed infants falls sharply during that period.
4. Continue to invest extra in existing and upcoming families with young children from Overvecht and Zuidwest and existing and upcoming families with young children of parents with an educational attainment up to VMBO, as children in these families are clearly less likely to have a promising start.
5. Focus on reducing smoking among (expectant) parents with a migrant background and among (upcoming) families living in Overvecht and Zuidwest.
6. Invest in healthy weight in children's first 1,000 days; by ages 2 and 3, there are already disparities in overweight by parents' educational attainment, and these disparities widen at primary school age.   

Publication date: September 2025