Roosy Aulakh*

Govt Medical College and Hospital, Chandigarh, India

*Corresponding Author: Roosy Aulakh, Govt Medical College and Hospital, Chandigarh, India.

Received: July 01, 2021; Published: July 26, 2021

Citation: Roosy Aulakh. “Nurturing Care for Early Childhood Development”. Acta Scientific Paediatrics 4.8 (2021): 60-61.

Introduction

We are all aware of the ‘Nature versus Nurture’ debate which has been ongoing since the conception of these two terminologies in 16^th century. Epigenetics has, more or less. put an end to this debate ruling out the possibility of exclusiveness of effect of either of the two on human development. The thought that some human characteristics are a result of genetic make-up and the rest due to environmental influences doesn’t seem to hold ground. Epigenetics has revealed that genes don’t function with ‘free will’ and are in turn affected by the environmental influences, a concept well documented by team of researchers led by Michael Meaney and Moshe Szyf at McGill University. Their experiments on rats showed that early life experiences can affect the functioning of genes having long term effects up to adulthood. Data, though limited, from studies on humans has supported this finding with an even more thought-provoking suggestion that epigenetic inheritance might indeed be possible and such a transgenerational epigenetic inheritance could tilt the balance towards Lamarckian inheritance from the well accepted Darwin’s Theory of genetic inheritance.

With the current understanding, we are confident that the care of human child in its formative years is a crucial determinant to its development as an adult; whether the effect could pass on to next generations is yet unclear. Nurturing Care (NC) refers to a stable environment created by parents and caregivers with support from policies, services and communities that ensures children’s good health and nutrition, protects them from threats, gives them opportunities for early learning, through interactions that are emotionally supportive and responsive [1]. WHO, UNICEF and the World Bank Group, in collaboration with the Partnership for Maternal, Newborn and Child Health, the Early Childhood Development Action Network and many other partners developed the Nurturing Care Framework as a roadmap for action. Early Childhood Development (ECD) refers to the cognitive, physical, language, motor, social and emotional development of children from conception to 8 years of age. It includes five major components: adequate nutrition, good health, security and safety as well as opportunities for early learning for the young child underpinned by responsive caregiving across all these domains.

Children who are not provided nurturing care are unable to achieve their potential and are more likely to be undernourished, in poor health, have poor scholastic performance, suffer from behavioural issues and grow to be financially weak adults. Nobel laureate James Heckman, in his ground-breaking work, has shown that the highest rate of return in early childhood development comes from investing as early as possible because skills beget skills in a complementary and dynamic way. Efforts should focus on the first years for the greatest efficiency and effectiveness [2]. Preventive and promotive interventions in the early years, thus, achieve more and cost less than remedial interventions at later ages. Interpersonal skills fostered through responsive caregiving secure affectionate relationships with caregivers which decreases chances of later indulgence in criminal activities or violence. Early intervention is not only cost effective but also increase success rate of future interventions by providing due confidence and motivation to the child.

Indian Academy of Pediatrics (IAP) is committed to adopt all the components of Nurturing Care for Early Childhood Development and attempt to have all the components incorporated into nationwide pediatric practice over next few years. In order to achieve this, numerous sensitization activities and consultative meetings have been held amongst stakeholders in order to plan

National, Zonal, State and District level workshops to undertake nationwide capacity building to promote innovative strategies to make all child care facilities ECD compliant [3]. We, pediatricians in collaboration with obstetricians, can utilize multiple opportunities to advance nurturing care through multiple interactions with parents or caregivers: antenatal and postnatal visits, immunization and well baby clinic visits and even outpatient or inpatient visits for sick child. Skilled counselling after establishing trust with caregivers can go a long way in providing knowledge and skills to empower caregivers in their ability to provide responsive care and early learning opportunities to their young children. Intervention packages should thus be applied at developmentally appropriate times during the life course, target multiple risks, and build on existing delivery platforms with feasibility of scale-up [4]. In addition, regular monitoring would be essential to collect ground level data and based on it, improvise and/or innovate our policies and activities in order to achieve desired outcomes.

Policies, services and interventions ensuring nurturing care to support early childhood development are essential to realising the vision of the Sustainable Development Goals. We should all strive for a world in which each and every child is provided with an enabling environment through support to parents and caregivers to develop his maximum developmental potential.

Bibliography

1. World Health Organization, United Nations Children’s Fund, World Bank Group. “Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential”. Geneva: World Health Organization (2018).
2. Heckman JJ. “Skill formation and the economics of investing in disadvantaged children”. Science5782 (2006): 19001902.
3. Mukherjee SB., et al. “Indian Academy of Pediatrics Position Paper on Nurturing Care for Early Childhood Development”. Indian Pediatrics (2021).
4. Britto PR., et al. “Nurturing care: promoting early childhood development”. Lancet 389.10064 (2017): 91-102.

Copyright: © 2021 Roosy Aulakh. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.