Early Childhood Education

Infant Care

Infant care generally refers to the nonparental care of children during the time period from just after birth to thirty-six months of age. Infant care options include care provided inside the child’s home by a family member, friend, or child-care provider; and care outside the home provided by a family member, friend, family care provider, or center-based child-care provider. A good percentage of the world’s infant care is unlicensed and unregulated and dependent upon informal arrangements between families and providers. The licensing of programs and providers varies widely and does not insure quality. Low quality is consistently linked with low salary, few benefits, little status, minimal training, and high adult to child ratios. When these factors are present, turnover in the field is high.

When the care they received is left unregulated or unplanned, started too early, provided by untrained caregivers or done in groups too large, or in environments unhealthy or unsafe, babies are put at developmental risk. Unfortunately, at least in the United States, this is most often the type of care provided. A recent study of infant care in the United States found that only 8 percent of infant-toddler care was judged as developmentally appropriate and 40 percent was judged as harmful (Cost Quality and Child Outcomes Study Team, 1995). This study was done in licensed centers.

Only sixty years ago most industrialized nations, including the United States, had similar visions with regard to the care of infants. Babies were cared for in the home of the parent or other family members and the family was responsible for the quality of care the child received. In the United States in 1940, 67 percent of all married couples had a wage-earning dad and a stay-at-home mom and this family- based system of care seemed to work (Oser and Cohen, 2003). But in the 1970s and 1980s family work and child-rearing patterns changed dramatically. Twenty four percent of mothers with children under one year were in the workforce in 1970, and by 1984 forty seven percent worked outside the home (Bureau of Labor Statistics, 1994). Most industrialized societies saw these risks as unacceptable and stepped in to protect infants and toddlers with paid parental leave during early infancy, liberal sick leave policies to care for sick children, and regulated and partially subsidized child-care services provided by trained workers. Few of these social adaptations happened in the United States, however, or in much of the nonindustrialized world.

Although much of the nonparental infant care provided throughout the world is of questionable quality, leaders in the field of early childhood education have identified conditions of high-quality care, including the acknowledgement that good infant-toddler care is not babysitting and not preschool. It is a special kind of care that looks like no other. For it to be designed well and carried out appropriately, all features—including lesson plans, environments, routines, staffing, group size, and relationships with families, supervision, and training— must have an infant care orientation. Because infants and toddlers have unique needs, their care must be constructed specifically to meet those needs.

Unfortunately, there is wide variation in how infant needs are interpreted. In the United States, for example, infant care has developed in two extreme directions. One orientation is guided by the conviction that all that infants and toddlers need are safe environments and tender loving care and that intellectual activity is unnecessary. Another interpretation of infant development and the role of infant-care argues that infants need to be intellectually stimulated by adult-directed and developmentally appropriate activities for them to grow cognitively. In many other nations infant learning is interpreted differently. In government-sponsored programs in Italy and Germany, for example, caregivers study the children in their care and keep detailed records of their interests and skills in order to find ways to facilitate the child’s learning. They are trained to search for ways to use the children’s natural interests and curiosity to develop appropriate curriculum activities and environments. In these settings, a good portion of what might be called lesson planning for infants and toddlers involves caregivers seeking to understand each child’s development and how to relate to it. Observation, documentation, analysis, and adaptation happen daily. What results is a program approach that combines loving relationship-based care as the essential prerequisite of intellectual development; attention to the child’s interests, curiosity, and motivation as the beginning point for curriculum planning; and adults who play the role of facilitator of the child’s learning.

In the United States, program policies that reflect child-focused infant care can be found in the Head Start Program Performance Standards and are being used as the base for Early Head Start operation. These polices, described in the Program for Infant-Toddler Caregivers literature, are being endorsed widely as foundational polices for quality infant care (Lally et al., 1995); and are outlined below.

Primary care

In a primary care system each child is assigned to one special caregiver who is principally responsible for that child’s care. When children spend a longer day in care than their primary caregiver, a second caregiver is assigned to also have a primary relationship with the child. Primary care works best when caregivers team up and support each other and provide a back-up base for security for each other’s children in primary care. Primary care does not mean exclusive care. It means, however, that all parties know who has primary responsibility for each child.

Small groups

Every major research study on infant and toddler care in the United States has shown that a small group size and good ratios are key components of good-quality care (Cost, Quality, and Child Outcomes Study Team, 1995; Kagan and Cohen, 1996). The Program for Infant-Toddler Caregivers in California recommends primary care ratios of 1:3 or 1:4 in groups of 6-12 children, depending on their age (Lally, 1992; WestEd, 2000). The guiding principle is: The younger the child, the smaller the group. Small groups facilitate the provision of personalized care that infants and toddlers need, supporting peaceful exchanges, freedom and safety to move and explore, and the development of intimate relationships.

Continuity

Continuity of care is the third key to providing the deep connections that infants and toddlers need for good-quality child care. Programs that incorporate the concept of continuity of care keep primary caregivers and children together throughout the three years of infant-toddler period or for the entire time during that period of the child’s enrollment in care.

Individualized care

Individualized care is interpreted as following children’s unique rhythms and styles, and is believed to promote well-being and a healthy sense of self. This principle discourages the use of embarrassment if a child’s biological rhythms or needs are different from those of other children. Responding promptly to children’s individual needs is assumed to support their growing ability to self-regulate, that is, to function competently in personal and social contexts. An individualized infant-care program adapts to the child, rather than vice versa, and the child receives the message that he or she is important; that her or his needs will be met; and that choices, preferences, and impulses are respected.

Cultural continuity

Children develop a sense of who they are and what is important within the context of the family and the larger cultural context. Traditionally, the child’s family and cultural community have been responsible for the transmission of values, expectations, and ways of doing things, especially during the early years of life. As more children enter child care during the years of infancy, questions are raised about their cultural identity and sense of belonging. Consistency of care between home and child care, always important for the very young, becomes even more so when the infant or toddler is cared for in the context of cultural practices that vary from those of the child’s family. Because of the important role of culture in development, caregivers who serve families from diverse backgrounds need to (a) heighten their understanding of the importance of culture in the lives of infants, (b) develop cultural competencies, (c) acknowledge and respect cultural differences, and (e) learn to be open, responsive to, and willing to negotiate with families about child-rearing practices. In this way, families and caregivers, working together, can facilitate the optimal development of each child.

Inclusion of children with special needs

Inclusion means making the benefits of high-quality care available to all infants through appropriate accommodations and supports in order for each child, including those with disabilities, to have full, active program participation. Strategies already embraced above—that is, a relationship-based approach to the provision of care that is responsive to the individual child’s cues and desires to learn—are as important for children with disabilities or other special needs as for children without these challenges.

For further information see the Program for Infant-Toddler Care Web site at www.pitc.org. See also Culture; Developmentally Appropriate Practice(s); Disabilities, Young Children with; Families; Teacher Certification/Licensure.

Further Readings: Cost, Quality, and Child Outcomes Study Team (1995). Cost, quality, and child outcomes in child care centers. Denver, CO: University of Colorado at Denver, Department of Economics; Head Start Bureau (1996). Head Start performance standard and program guidance; Code of Federal Regulations, Title 45, Parts 1301-1311. Washington, DC: U.S. Department of Health and Human Services, Administration for Youth and Families, Kagan, S. L., and N.E. Cohen (19979. Not by chance: Creating an early care and education system for America’s children. New Haven, CT: The Bush Center in Child Development and Social Policy; Lally, J. R. (1992). Together in care: Meeting the intimacy needs of infants and toddlers in groups (videotape). Sacramento: California Department of Education and WestEd; Lally, J. R., A. Griffin, E. Fenichel, M. Segal, E. Szanton and B. Weissbourd (1995). Caring for infants and toddlers in groups: Developmentally appropriate practice. Washington, DC: Zero to Three, National Center for Infants, Toddlers, and Families; Oser, C., and J. Cohen (2003) America’s Babies: The Zero To Three Policy Center Data Book. Washington, DC: Zero to Three Press; WestEd (2000). The Program for Infant-Toddler Caregivers: Group care. 2nd ed. Sacramento: California Department of Education.

J. Ronald Lally