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The purpose of this perspective article is to emphasise the importance of the 'First 2000 Days' policy of life from conception to age five, and to propose new directions in which the policy's implementation could be extended for the benefit of children and families. The proposed approach highlights principles of responsiveness, integration, sustainability and equity, specifying initiatives that embody the kind of innovation each principle aspires to. The article also proposes innovations in data collection and linkages that would strengthen the implementation of first 2000 days policies and frameworks. This perspective proposes a framework that could improve health systems implementation of services in the first 5 years of life, by proposing a well-coordinated continuum of services with integrated physical and digital solutions. This has the potential to transform how the health system monitors and responds to children and families' needs in the critical early years of life during and beyond the current pandemic. What is known about the topic? The 'First 2000 Days' policy is publicly available, it represents an important effort to highlight the importance of the first 5 years of life for a child's development. This policy and others like it have been broadly adopted around Australia. What does this paper add? This paper is a constructive critique of the policy that suggests greater responsiveness, integration, sustainability and equity. What are the implications for practitioners? This paper helps us understand how best to shape early childhood health services so they can be most effective. [ABSTRACT FROM AUTHOR]