Promote Health and Safety in Infant/Toddler Child Care

Apr 15, 2010

By Rachel Schumacher

As they develop from birth to age 3, young children rely on the adults who care for them to keep them clean, dry, fed, and safe from harm. All babies and toddlers in child care need healthy and safe environments in which to explore and learn. Babies and toddlers have immature immune systems and engage in behaviors that make them particularly vulnerable to illness. In addition, extra precautions are necessary to design a physical environment that anticipates the various stages of infant/toddler development. For example, infants may not yet be able to hold up their heads or roll over, and toddlers may not yet understand the dangers of water, stairs, or pets. Although overall fatality rates are low for children in child care, babies may be more likely to experience fatalities than older children. Still, few states hold centers or family child care homes to standards which are linked to safer and healthier care, such as recommended provider-to-child ratios for babies and toddlers, small group sizes, and sufficient age-specific training prior to caring for children.

Research shows that provider and caregiver training specific to the health and safety needs of young children can be effective, particularly when paired with follow-up, supports, and monitoring. Simple training and ongoing monitoring of diapering and handwashing practices, for instance, have been shown to reduce the incidence of illness. In general, however, providers who work directly with children in child care settings are not likely to have had training prior to service. As of 2007, only 13 states required any specific training before caring for children in a child care center, although 48 states have ongoing annual training requirements. For family child care homes, only nine states have pre-service training requirements and 12 more have requirements that must be met in the initial few months of licensure.

There are several steps states can take to improve health and safety conditions for babies and toddlers in child care. A first step might include studying current health and safety practices in child care settings for babies and toddlers that can be used to identify different areas of need among types of care, regions of the state, or particular aspects of health and safety. For example, Massachusetts conducted a health report with observers trained in ITERS to look at specific areas where centers and FCC could improve on licensing. States can also compare current licensing rules to the standards recommended in the seminal report, Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs.

More ideas and information are available in new resources from CLASP's Charting Progress for Babies in Child Care project. Users can access a wide range of information, including research to "make the case" for promoting infant/toddler health and safety; a research bibliography; policy ideas for states; state examples; and online resources.

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