This paper is concerned with the co-opting of neuroscientific findings into social work practice with infants at risk of harm. The value of neuroscience to our understanding of infants and infant care remains contested. For ‘infant mental health’ proponents, neuroscientific findings have become a powerful tool in arguing for the importance of nurture and care in the early years. However, critical perspectives question the selective use of neuroscientific evidence, and the impact that the ‘first three years’ agenda has actually had on families. In social work, much of our involvement with very young children is centred around risk. It is also concentrated on children born into families and communities experiencing multiple disadvantages. The emphasis on the vulnerability of infants and very young children has changed child protection social work in significant ways. Many of the children subject to child care and protection measures are very young, or not yet born. This paper draws upon findings from a study which followed families through the process of pre-birth child protection assessment. It is argued that it is necessary to engage critically with the ‘first three years’ narrative that has become dominant in Scottish policy making and the impact this has had on child protection practice and the lives of families. The paper argues for a broader interpretation of ACEs focused on community and public health across the life course.