Caring for Infants and Young Children
Caring for infants and young children is a multifaceted responsibility that extends beyond basic physical needs to encompass emotional, social, and cognitive development. Parents and caregivers must navigate the challenges of feeding, bathing, and soothing newborns, while also recognizing the importance of stimuli such as touch, sound, and interaction for healthy growth. As children transition into toddlerhood, caregivers can support their burgeoning independence by providing choices and establishing routines that promote self-control and autonomy. Safety is a paramount concern, with measures needed to prevent accidents and illnesses, including proper use of car seats and awareness of Sudden Infant Death Syndrome (SIDS) guidelines.
Additionally, the growing trend of childcare outside the home necessitates well-trained caregivers who understand developmental milestones and can address behavioral issues. This need is underscored by research indicating that many developmental problems go undetected in routine medical settings. Caregivers and parents are encouraged to foster respectful relationships and continuity of care in childcare environments, thereby enriching the early experiences of infants and toddlers. Overall, effective child-rearing practices require collaboration, training, and a commitment to nurturing children's growth in a safe and supportive atmosphere.
Caring for Infants and Young Children
Parents and caregivers can each benefit greatly by reaching a consensus on approaches for the important responsibility of caring for infants and children. In addition to providing physical comfort and care, infants thrive when provided certain other stimuli. Parents and caregivers need to know how to detect and manage possible developmental and behavioral problems. The increasing number of infants and children in the care of childcare providers calls for more training for caregivers. Caregivers need to competently address the necessary considerations for emotional, social, and cognitive child development for infants and toddlers in groups.
Keywords Caregiver; Childcare; Child Development; Child Safety; Early Childhood Teachers; Immunizations; Infant; Newborn; Toddler
Overview
Ever since the first baby entered the world, there's been continuous and contentious discussion over how to care for these unpredictable, defenseless creatures. Theories and ideas on child-raising have been changed over the years about as often as diapers. With advances in communication, the psychology of child development, health and medicine creating a profusion of information on child-raising, parents and caregivers can benefit through a consensus on how to care for and nurture infants and children.
From day one, caring for a newborn is a tremendous challenge for first-time parents. Feeding, bathing, sleeping, and wakeful times are all new experiences for the new family. In addition to physical care and comfort, babies thrive on additional stimuli, such as sights, sounds, touch, and love.
Through the first months, parents and caregivers face challenges of how to handle fussy infants. During the first years, parents and caregivers need to know how to detect and manage possible developmental and behavioral problems. Another important responsibility for parents and caregivers of small children is to take measures to protect their safety. These include ensuring a safe environment to prevent the growing child from injury, illness, danger, or accidental death.
With both parents working, infants and young children may be cared for out of the home, in group childcare facilities. Training for caregivers in these childcare facilities helps them to competently address the necessary considerations for emotional, social, and cognitive development of infants and toddlers in groups. As toddlers begin to develop the need to assert independence, caregivers can ease their journey through this developmental phase. By providing appropriate choices, the child can learn to feel a heightened level of autonomy and self-control.
Application
Caring for Newborns
Caring for a newborn is a challenging responsibility for new parents or caregivers. An immediate consideration involves feeding the baby. According to the Journal of the American Medical Association, the mother should decide whether to breastfeed or bottle-feed before the baby is born. The AMA recommends feeding newborns on demand, usually "every 2 to 3 hours in the first month, and less frequently as he or she grows older" (quoted in Hwang, 1999, p. 1200). The AMA suggests tips for bathing a newborn, the proper environment and position for sleeping. It also cautions against smoking around the baby and or exposing the infant to excessive sunlight. The association also outlines a schedule for visiting a doctor. Regarding immunizations, the AMA says, "Your baby needs to get a number of vaccinations within the first year that protect against 10 major childhood diseases" (quoted in Hwang, 1999, p. 1200).
Part of the doctor's exam at birth is to check the baby's sensory reflexes to assure that the baby can see and hear, and later to determine that the sense of taste and smell are fine. Alice Honig (2005) presents the importance of touch as a crucial sense for babies. She writes, "Touch is a magical ingredient that promotes healthy growth," referring to research done with premature babies. "When nurses provide gentle massages to babies' bodies several times a day, those babies gain weight faster and are released from the hospital several days earlier than premies who had not been massaged. Further research also shows that "loving touch massages permit young children to fall asleep faster and more easily" (Honig, 2005, p. 25). Honig adds that some children have sensory-integration difficulties regarding the sense of touch, explaining that some babies become irritable if stroked too softly (Honig, 2005, p. 25).
Learning how to interpret a newborn's language is an acquired and individualized skill. Amy Dickinson (2001) reports how British nanny Tracy Hogg listens to babies and "reads" their language. Affirming that babies try to communicate their needs, she acknowledges that parents are often too tired or perhaps too close to figure out what the baby is trying to communicate. Hogg recommends backing off a bit, which allows the parent to watch and listen more objectively. To aid parents in learning the difference between a "hungry" cry and a "tired" cry, she suggests putting babies on a modified, "structured routine." She advocates a flexible schedule, based on "a baby's natural rhythms of eating, activity, napping and sleeping at night" (Dickinson, 2001, p. 78). She believes that establishing predictable routines, such as a soothing bedtime ritual, are likely to calm babies.
Over the years, child psychologists have offered varying views on what to do when an infant or toddler is fussy. Advice ranges from immediately picking up the child to letting the child cry it out to a variety of strategies in between. An article titled "Caring for Fussy Infants and Toddlers" points out several key guidelines pertinent to the group childcare setting. The guidelines for caring for infants include minimizing the number of persons caring for the baby, being empathic to help the baby anticipate changes, and using soothing tones and calm gestures to help the baby relax. Babies benefit when the caregiver takes adequate time to help the baby become familiar with the routines, sights, sounds, and play environments. Fussy babies adapt more calmly to their environment when the amount of stimulation is pared down. For toddlers, the advice is to be flexible and generous with time, provide ample large-motor equipment, especially for high-energy toddlers, watch for signs of emotional overload, use distractions to divert a toddler from behavioral conflicts, give toddlers words for emotions and help them vocalize such situations as "I want a turn," or "I need that block." Finally, when transitioning an irritable toddler to another activity, caregivers should move several of the child's friends at the same time (Early Childhood Today, 2005).
Many parents of infants and toddlers work alternative shifts, perhaps during the evening and night hours, and require childcare beyond the traditional daycare schedule. As a result, extended-hour and nighttime childcare centers help to care for children of parents working nonstandard hours. In their study, Moon, Weese-Mayer and Sylvestri (2003) recognized that 20% of sudden infant death syndrome (SIDS) cases occur in childcare settings and that childcare providers may place infants in the more vulnerable prone position. Their study reported on the American Academy of Pediatrics' "Back to Sleep" educational campaign which dramatically decreased the incidence of SIDS. "Despite this remarkable progress in SIDS risk factor education and practice, a 1996 study revealed that 43% of licensed childcare centers lacked awareness of the association of SIDS and infant sleep position, and a follow-up study in 1999 documented that despite an increased awareness, 25% of licensed childcare centers continued to place infants prone to sleep" (Moon, Weese-Mayer & Sylvestri, 2003, p. 795). The primary reason cited for why nighttime childcare providers continue to place infants prone to sleep seemed to stem from the evidence that the providers are misinformed about the risks and benefits of the various sleep positions. A traditional reason for avoiding the supine position relates to the false belief that the baby might choke. The authors cited research confirming that prone infants sleep deeper and have higher arousal thresholds. Additional factors in an infant's sleep environment were studied, including type of equipment used (bed, crib, playpen, bassinet, infant swings, or unspecified non-crib area), use of blankets, comforters, or pillows, and whether the facility allowed the children to have stuffed toys, pacifiers, or bumper pads. The study also reviewed smoking policy, finding that while most prohibited smoking on the premises, there were, incredibly, no restrictions on smoking in a few of the childcare centers. The authors recommend that parents need to be proactive in evaluating childcare centers to make sure that safe sleep practices are taught and implemented (Moon, Weese-Mayer & Sylvestri, 2003).
Caring for Toddlers
When children mature to three and four years of age, they start to assert their independence. As toddlers, they start to differentiate self from outside direction. According to Louise Pavia and Denise Da Ros (1997), this stage is an important one for a toddler and one in which a parent or caregiver can exert influence in a positive way. "The toddler must emerge from this state with a stronger sense of self as experienced through opportunities that encourage independence through developmentally appropriate choices. Consequently, young children will experience a sense of self-control without loss of self-esteem" (Pavia & Da Ros, 1997, p. 67). Examples cited are a two-year-old who refuses to have her diaper changed. The caregiver poses choices for the youngster: "Would you like your diaper changed now or after I change Brent's diaper?" A frequent source of power struggles is mealtime, with children attempting to assert their will against a parent's wisdom for healthy nutrition. Pressuring children into eating when they are full or eating foods they don't like can have negative implications on future food habits and proper diet. Naptime is another arena for potential conflicts. Caregivers are advised to help children make the transition from wakefulness to sleep, through careful observation and communication with parents. Key here in reducing power struggles with young children is to work at considering individual needs while remaining sensitive to adult issues of time and space. The authors conclude that by providing toddlers with choices, caregivers can avoid a power struggle. Recommended techniques for developing a child's autonomy include establishing predictable but flexible daily routines and balancing the meeting of a child's individual needs with adult concerns (Pavia & Da Ros, 1997).
Early Childhood Teacher Certification
A growing number of early childhood teachers are seeking or have been awarded certification from the National Board for Professional Teaching Standards. Emphasizing the value and importance of education and certification for teachers, Jacobson (1975) reports that the Arlington, VA-based National Board for Professional Teaching Standards (NBPTS) and the National Association for the Education of Young Children-a Washington-based professional association for those in early childhood education-are actively promoting national certification among early childhood educators. One standard for preschool certification is the ability to understand how young children learn. To earn certification, teachers must pass exams in their specialty areas (Jacobson, 1975).
Child Saftey
One cannot overlook considerations of child safety, the physical safety and protection of the infant and toddler, in this discussion. According to Frances Biagioli (2005), automobile crashes are "the leading cause of death for children younger than 14 years, but safety seats reduce childhood injury and death" (Biagioli, 2005, p. 473). She emphasizes several key aspects of child safety seats. "Backwards is Best" means that infants are safest in a head-on crash when they're facing the rear of the vehicle in which they are traveling. "20-40-80" identifies the three weights at which children are most likely to transition from one child safety seat to another-the right fit is crucial. "Boost Until Big Enough" focuses on the fact that a booster seat should be used until children are big enough to fit in an adult safety belt (Biagioli, 2005).
Making their way onward to adolescence, youngsters benefit by positive community involvement. Linda Beck (2006) quotes the African proverb, "It takes a village to raise a child," as foundation for community organizers and agencies who effect change among children and teens. These include a "coffee company in Iowa and a Lutheran church teen group in Pennsylvania," with programs aimed at strengthening kids to deal with school, home life, and jobs (Beck, 2006, p. 104).
Viewpoints
Childcare Providers
Parents who work outside the home often use childcare centers to care for their infants and children. According to Lally, Torres, & Phelps, (1993), an increasing number of children are moving into group care at younger ages and for longer periods of time. If done well, these external childcare centers can enrich a child's early experiences. However, current practices in many infant/toddler childcare settings actually hinder caregivers, children, and parents from forming respectful relationships (Lally, Torres & Phelps, 1993).
Lally et al. postulate that there are two sources of current problems: the traditional view that childcare can be provided by untrained, non-professionals and the practice of childcare by people who are unfamiliar with infants and/or unfamiliar with groups. The authors identify six key components of successful early group experience. First, they point to smaller groups of infants or toddlers per adult caregiver. Second on their list are physical environments that promote intimate, satisfying relationships by removing dangerous objects, furnishing a place for parents to sit comfortably for a moment before taking the child home, and an abundance of play materials. The third aspect focuses on identifying a primary caregiver for each child, so that the infant or toddler has an individual caregiver with whom to build an intimate relationship. The fourth directive on the list focuses on providing continuity of care, with the same caregiver during the years of stay. Fifth is cultural and familial continuity, whereby childcare is in harmony with what goes on at home. And sixth includes meeting the needs of the individual within the group context, allowing a flexible schedule for the child wherever possible.
Behavioral & Developmental Problems
Diagnosis and management of child behavioral and developmental problems is often left in the domain of the pediatrician, family practitioner, or the child's teachers. However, according to Drotar (2004) significant numbers of infants and young children with behavioral and developmental problems, such as sleep disturbance, irritable behavior patterns, and problems relating to behavioral control may not be discerned in the doctor's office setting. As a consequence, considerable opportunities for early attention and treatment of such problems may be missed. Research has consistently noted that large numbers, anywhere from 12% to 25% of children who are seen in primary care, have significant psychosocial problems, but for these children only a small percentage of the cases are identified and referred for treatment. Several reasons are cited, including time constraints on the professional's schedule, concern about incorrectly labeling children, limitations on insurance coverage for further evaluation, and concern over available systems of diagnostic categorization of infants and children with behavioral and developmental problems (Drotar, 2004).
Drotar describes the Diagnostic and Statistical Manual for Primary Care (DSM-PC), a helpful coding system for classifying and managing behavioral and developmental problems of infants and children. Core elements of the DSM-PC are a "Situations" section, "designed to help practitioners to describe and evaluate the impact of stressful situations that present in primary care and community settings and can affect children's mental health." Examples include challenges to primary support group; e.g., marital discord/divorce; changes in care giving; physical illness of parent; and other factors such as housing, economic, or educational challenges. The second major content area of the DSM-PC delineates child manifestations or symptoms. These children's symptoms are grouped into ten domains, such as negative/antisocial behaviors, substance use/abuse; emotions and moods; and impulsivity, hyperactivity, and inattention disorders as a way of categorizing the developmental problems (Drotar, 2004).
Terms & Concepts
Caregiver: The individual who has the principal responsibility for caring for a child or dependent adult, especially in the home or in a designated facility.
Childcare: The care and supervision of children by an adult, inside or outside the home and usually for pay, during times when the parents or guardians are at work.
Child Development: The study of processes that operate during the physical and mental development of an infant into an adult.
Child Safety: Measures taken to protect a child from suffering physical injury, hurt, or loss. Areas of concern include child seats in automobiles, prevention of Sudden Infant Death Syndrome, play equipment and toys, and the home and nursery environment.
Early Childhood Teacher: An educator who works with young children (children from infancy to age 8) in a classroom setting. Early childhood education strives to nurture the child's academic, emotional, physical and social development during this age range, often in the absence of the child's primary caregiver.
Immunizations: Vaccinations and inoculations against disease, usually received before age one or two.
Infant: A baby, a very young child that can neither walk nor talk.
Newborn: A new baby, born very recently.
Toddler: A young child who is learning to walk.
Bibliography
Beck, L. (2006). All kids are our kids: What communities must do to raise caring and responsible children and adolescents. Library Journal, 131 , 104. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=22977448&site=ehost-live
Bergelson, E., & Swingley, D. (2013). The acquisition of abstract words by young infants. Cognition, 127, 391-397. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=89076435&site=ehost-live
Biagioli, F. (2005). Child safety seat counseling: Three keys to safety. American Family Physician, 72 , 473-478. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=17831674&site=ehost-live
Caring for fussy infants and toddlers. (2005). Early Childhood Today, 19 , 21. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=16716540&site=ehost-live
Dickinson, A. (2001). Translating babies. Time Europe, 157 , 74. Retrieved December 18, 2006, from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=4940557&site=ehost-live
Drotar, D. (2004). Detecting and managing developmental and behavioral problems in infants and young children. An Interdisciplinary Journal of Special Care Practices, 17 114-124. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=12612748&site=ehost-live
Honig, A. S. (2005). The power of touch. Early Childhood Today, 19 , 25. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=16443431&site=ehost-live
Hwang, Mi Young. (1999). Caring for a newborn baby. Journal of the American Medical Association, 282 , 1200. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=2313276&site=ehost-live
Jacobson, L. (2002, November 27). The path to pre-k prestige. Education Week, 22 , 25. Retrieved January 13, 2007 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=8612978&site=ehost-live
Lally, J. R., Torres, Y. L., & Phelps, P. C. (1993). Caring for infants and toddlers in groups: Necessary considerations for emotional, social, and cognitive development. Zero to Three: National Center For Infants, Toddlers and Families. Retrieved December 18, 2006, from Zero to Three http://www.zerotothree.org/caring.html
Messmore, C. (2012). Diagnosis of infants and very young children: A review of the two classification systems. Counseling & Human Development, 44, 1-8. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=79564794&site=ehost-live
Moon, A., Weese-Mayer, D. E., & Silvestri, J. M. (2003). Nighttime child care: Inadequate sudden infant death syndrome risk factor knowledge, practice, and policies. Pediatrics, 111 , 795. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=9424664&site=ehost-live
Pavia, L. S., & Da Ros, D. (1997, September). Choice: A powerful tool in caring for toddlers. Early Childhood Education Journal, 25 , 67. Retrieved December 18, 2006 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=11305033&site=ehost-live
Stein, A. A., Malmberg, L. E., Leach, P. P., Barnes, J. J., & Sylva, K. K. (2013). The influence of different forms of early childcare on children's emotional and behavioural development at school entry. Child: Care, Health & Development, 39, 676-687. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=89730698&site=ehost-live
Suggested Reading
Burton, A. (2006). Caring for children amidst chaos. Environmental Health Perspectives, 114 , A584-A591. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=22882788&site=ehost-live
Cloud, H. J., & Townsend, J. (1999) Raising great kids. Grand Rapids, MI: Zondervan.
Gillis, J., & Fise, M. E. R. (1986). Review of the book The childwise catalog: A consumer guide to buying the safest and best products for your children, newborns through age five. Magill Book Reviews/Salem Press.
Walmsley, C., & Moyse, K. (2006). Sure start. Pediatric Nursing, 18 , 30-33. Retrieved December 18, 2006 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=20418256&site=ehost-live