Increasing attention is being paid to giving all children in the Netherlands a healthy start in life. Nearly all municipalities now offer initiatives to support parents, parents-to-be and children as part of the national Solid Start approach. Even so, there has been no improvement to young children’s health over the past few years. More than 10 per cent of two-year-olds are overweight, compared to just 8 per cent in 2018. In 2024, following a years-long decline, there was also a slight increase in the number of children born into families living in difficult circumstances. This is according to the Dutch National Institute for Public Health and the Environment (RIVM)’s latest report on the progress of the Solid Start approach.
Under the Solid Start approach, municipalities have been able to set up initiatives with relevant parties to support parents before, during and after pregnancy since 2018. Since 2019, on behalf of the Dutch Ministry of Health, Welfare and Sport, RIVM has been monitoring the extent to which such initiatives have been established and how young children’s health is developing. This is the seventh report.
More local agreements and initiatives
In 2025, most municipalities (92 per cent) had established agreements with parties such as midwives, maternity care organisations and well-baby clinics concerning the Solid Start approach. Collaboration is important to ensure that problems are identified early, timely referrals are made, and existing or expectant parents receive the support they need. In addition, nearly all municipalities offer an increasing number of initiatives as part of the Solid Start approach, such as Nu Niet Zwanger (Not Pregnant Now). This initiative helps people have open conversations about whether they want to have children, sexuality and contraception.
Less positive health trends
Despite increasing collaboration, the health outcomes for children and parents present a less positive picture. Mental health problems among pregnant women and their partners are increasing. In addition, a third of women experience symptoms of depression, anxiety, or high levels of stress, after giving birth. The proportion of pregnant women and their partners with substantial debt has also risen slightly, as has the proportion of children born prematurely or with a low birth weight. In every case, these figures are higher among families in vulnerable situations. These developments are in line with broader trends in the Netherlands concerning debt, mental health and being overweight.
Solid Start as support for families in difficult circumstances
The Solid Start approach provides ways to support families in difficult circumstances and address health problems by providing early, integrated support during the first 1,000 days of a child’s life. As a result, risks affecting families in difficult circumstances can be identified earlier, and support for health problems, financial concerns and mental health problems can be better coordinated. RIVM sees various opportunities to improve the impact of Solid Start. So far, few municipalities have involved experts by experience as well as parents and parents-to-be in developing the initiatives. It is important to involve them in developing the initiatives so that these closely reflect parents’ needs. It is also important to gain a greater insight into who participates in the initiatives and whether they contribute to a promising start.
That requires sustained, targeted collaboration and the structural involvement of the target group at national, regional and local levels. By continuing to invest in children’s first 1,000 days in this way, Solid Start can make a greater difference, particularly for families experiencing health problems or living in difficult circumstances.