Children's Hospital Colorado

Addressing Prematurity: The First 1,000 Days of a Child’s Life

Why addressing prematurity matters

In the United States, about 1 in 10 babies is born prematurely each year; prematurity is the second leading cause of infant mortality at a rate of 107 per 100,000 births. In Colorado, that translates to 128 babies born preterm each week. The Children’s Hospital Colorado population in this age group is 40,000 individual children participating in over 117,000 visits to Children’s Colorado providers.

According to the CDC, childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. As such, early experiences are an important public health issue. Much of the foundational research in this area has been referred to as Adverse Childhood Experiences (ACEs).

Examples of ACEs include: Parental divorce/separation; emotional abuse; having a substance-abusing household member; physical abuse; living with someone who had a mental illness; sexual abuse; and domestic violence, among the most common. ACEs are common among adult Coloradans, with 61.7% being exposed to at least one type of ACE. More than one-third of adults have a history of multiple types of ACE. Nearly 15 percent of adults experienced four or more ACEs, and some adults have a history of all eight types (0.4%. (Colorado Essentials for Childhood)

We now know that what happens to children during the first two years of life makes an impact on lifelong health and well-being. While positive interactions help build the foundation for a healthy mind and body, adverse experiences and environments can negatively affect development and well-being. Young children depend on their caregivers to protect them from negative experiences and events.

When young children are exposed to negative experiences or events and don’t have caregivers who can support them and buffer them from the stress, they may experience Toxic Stress. This means that healthy development is derailed by excessive or prolonged activation of stress response systems in the body and brain (Harvard University Center on the Developing Child).

Such toxic stress can damage the healthy development of a child. Positive interactions help build the foundation for a healthy mind and body, while adverse experiences and environments can negatively affect development and well-being.

Let's address prematurity together

Learn what we're doing to address prematurity and how you can get involved in these initiatives.

First 1,000 Days priority areas

Public-Awareness-Campaign.jpgGoal #1: To increase awareness

We’re aiming to increase universal awareness of the importance of a child’s first thousand days of life using a broad media campaign to reach caregivers, community members and providers who work with young children and their families. Web and text-based resources and information will offer more in-depth information.

Related initiatives:

Goal #2: To assess our own policies and work environment

We’re focused on improving Children's Colorado’s position as a policy advocate by assessing the hospital’s own internal family-friendly policies, particularly those that impact the caregivers of young children, and creating a “best-in-class” work environment to benefit those caregivers.

Related initiatives:

Provider-Training.jpgGoal #3: To increase provider awareness and understanding

We’re working to increase healthcare provider awareness and understanding of the importance of the First 1,000 Days by offering comprehensive and impactful training to all levels of our medical staff. Training efforts will expand to providers at pediatric and family practices outside of the Children's Colorado network.

Related initiatives:

Screening--Identification.jpg​​Goal #4: To implement psychosocial screening within our hospital

We are working on implementing universal psychosocial screening using standardized tools in key departments within Children's Colorado to identify young children at risk or already facing adversity. We will then provide triage, referral, care coordination and targeted interventions to those families whose personal circumstances are negatively impacting the health of their children.

Related initiatives:

Targeted-Interventions.jpg​​Goal #5: To expand partnerships to help more babies and young parents

We’re expanding partnerships with pre-natal and early childhood providers in order to reduce premature births, increase referrals to pediatric settings that prioritize social and emotional health, and ensure more babies and young parents receive care with medical homes.

Related initiatives:

We’re in this together. See how our First 1,000 Days Initiative at Children’s Colorado aligns with other state initiatives and efforts.

For more information or questions, please contact Abby English Waldbaum or Dr. Ayelet Talmi at

The impact of trauma, neglect or abuse on a baby has a striking correlation to chronic disease, mental illness and other social problems in adults. This discovery unveils an important truth: Negative early experiences for children are not isolated family matters; they’re a public health issue.

The clinical work of Dr. Ayelet Talmi, a pediatric psychologist at Children’s Hospital Colorado, points to the lifelong impact of early childhood development. This body of work spurred collaboration among organizations, including Children’s Colorado, to align on a highly effective outreach strategy to promote health and well-being for young children and their families.

A key partner organization was nonprofit The Civic Canopy, which uses a community-learning model to drive transformational change through bringing together diverse partners. “When we were getting a myriad of people to come together to develop this shared messaging bank, it took Children’s Colorado coming to the table to make it happen,” says Stephanie Monahan, a director with Civic Canopy. “Given all we’ve learned about early childhood, toxic stress and the need to promote community resiliency, our ties and partnerships have grown even stronger.”

The Early Childhood Colorado Partnership (ECCP) unites over 600 cross-sector partners from all over the state in developing a shared message about the importance of mitigating toxic stress in early childhood development. This message has started critical dialogue on how a community can and needs to come together to ensure healthy development for their kids.

What you can do to address prematurity

Learn more

Toxic Stress

Adverse Childhood Experiences (ACEs)

Learn more from these Centers for Disease Control and Prevention Resources, which include tools on how to prevent ACEs, case studies on how states have used ACE data to inform child abuse work, select ACE-related journal articles, fact sheets to understand child maltreatment, select news articles, and more on prevention programs.

Mental Health


  • CDPHE Pregnancy-Related Depression : Pregnancy-related depression is depression that occurs during pregnancy or after giving birth, including after a pregnancy loss. In Colorado, nearly 1 in 9 women who give birth will experience signs and symptoms of depression. This makes depression the most common complication of pregnancy.
  • CDPHE’s guidance on “Marijuana and Your Baby” : Marijuana is now legal for adults over 21. But this doesn’t mean it is safe for pregnant or breastfeeding moms and babies

Get Involved

  • Child Health Champions: All of our advocacy efforts rely on the strength and action of Children's Hospital Colorado Grassroots Advocacy Network.  This is a group of people who care about kids' health and well-being and want to make a difference. Advocates write letters, make phone calls, and share information when needed to influence public policies. Join the Network now!
  • ZERO TO THREE: ZERO TO THREE is a national, nonprofit organization that provides parents, professionals and policymakers the knowledge and know-how to nurture early development.
  • Early Childhood Colorado Framework: This Framework is a shared vision for Colorado’s young children and their families. It guides planning and mobilizes action to ensure all children are valued, healthy and thriving. The Framework is embraced by the Early Childhood Leadership Commission, foundations, state agencies, nonprofits and early childhood stakeholders across Colorado.
  • BUILD Health Challenge: Our mission is to accelerate the number and effectiveness of cross-sector collaborations to improve population health.
  • Vroom: Vroom turns shared moments into brain building moments. Whether it’s mealtime, bathtime, or anytime in between, there are always ways to nurture our children’s growing minds.
  • Brain Child Magazine: The Magazine for Thinking Mothers, founded in 2000, is an award-winning literary magazine dedicated to motherhood.
  • Center for Youth Wellness: As health professionals who work with children—whether we’re pediatricians, nurses or medical assistants—it is our job to help our patients get a healthy start that gives them a good chance to live long, healthy lives.

Find Resources Near You

  • Breastfeeding Management Clinic at Children’s Hospital Colorado: The Breastfeeding Management Clinic provides a comprehensive approach to breastfeeding challenges for the baby and family.
  • Colorado Institute for Maternal and Fetal Health: The Colorado Institute for Maternal and Fetal Health offers mothers and babies comprehensive care and treatment before, during and after high-risk or routine pregnancies.
  • Kansas Home Visiting: Home visiting is a voluntary program that involves meeting with a trained, family-support professional at a time convenient for you and your family. Home visitors provide new or expecting parents with resources to keep themselves and their children safe, healthy, and nurtured.

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