Providing the healthiest and safest environment in the first 1,000 days of life is the greatest gift which parents can give to their children. We return to the theme of control over our lives to ask who is in control of this gift, and whether today’s medicine and public health hold the answers. We explore the dilemmas facing today’s governments and the decisions that individuals make in terms of personal responsibility when maternal and child health are not prioritised by health policy-makers. We discuss sexual and reproductive rights, why women’s health has not been prioritised – especially during the pandemic – and reasons for high maternal mortality in some countries. We offer an optimistic close to the book; a call to action. We explain that, while planning for parenthood is important, the actions needed do not have to be sustained over a long period. We emphasise the many opportunities which adolescents and young people can seize as the parents of the future. This hope can generate the resolve to make the first 1,000 days of life as good as possible for the next generation. Knowing the secrets of our first 1,000 days is a vital part of this.

None of us can really remember anything about our lives before the age of two years. How much of what makes us what we are has been set by that time? We challenge the widely-accepted idea that what we are is ‘determined’ by inherited genes and we start to explore how interaction with parents/carers establishes our behaviour. We use examples drawn from fiction and the real world to explore how the brain learns from the conditions in early life. We explain why this adaptability underpins development of our senses, our behaviour and our self-control. This introduces control as one of the themes of the book – how much we are in control of our bodies and how control develops based on environmental cues. We question what effect today’s exposure to digital media may have on the developing brain, and explore new ideas about the development of defence mechanisms, from immunity to the gut microbiome. Through the quote from JM Barrie, author of ‘Peter Pan’: ‘You always know after you are two. Two is the beginning of the end’, we ask whether age two is the beginning of the end or the end of the beginning of development.