surely we can emancipate women, and not abandon children to indifferent care?


This all begins thirty years ago with a phone call. A friend, a young mother is on the line, distraught. Its her first day back at work after four months maternity leave. Her little boy is at a nearby nursery, howling in despair. She is howling too. A swarm of cliches hover on my lips - "he will be fine, the staff know how to look after him", but instead I take it slowly, asking how she got to this point.

A familiar story to me now, thirty years later. Her husband, her boss want her back at work, her whole peer group are doing the nursery thing - but in her heart, she has never really asked - what do I want ? And its taken this to find out.

By the end of that day, and with no prompting from me - for in those days I was a "quality care" believer like everyone else, she is back home again, and doesn't return to work for eighteen months more. And I am launched on a journey of concern.

What do we do to young parents in our society? We think we are free to choose our lives, but pressures from all around, not least the housing price crisis facing the UK, mean women, like men have become more enslaved now than when feminism first stormed the barricades. The tyrant has changed, the choices are just as poor.

And then there's the babies, lying in rows of cots, then milling about in garish rooms through their toddler years, aching for one special adult to love them. 12,000 hours of this before they set foot in school.

Childhood today is nothing like it was for preceding generations, especially for very young children. In 1981, only 24% of mothers returned to work before their baby was one. Today the figure is near to 70%, with 95% of fathers working full-time. As a result, almost a quarter of a million British children under three attend a day nursery full- or part-time.

Daycare was originally intended for three- and four-year-olds, but its use has spread downwards; sometimes babies are now put into nurseries when they are just days old. The hours have got longer too: throughout the industrialised world, millions of children under three are there for 10 hours a day, five days a week.

This large-scale group care of the very young is a recent thing. It has happened without prior research or understanding (compared with, for instance, the invention of kindergarten, which was designed with child development needs in mind).

The invention of daycare, nurseries, home carers and nannies is an absolute necessity given our newly hurried lives. Today, you can be a parent without being a parent. Day nurseries are an attempt - whether motivated by idealism or corporate greed - to slot messy and needy young children into the new economic system, while at the same time reassuring us that it is good for them, socially and educationally.

Nurseries are marketed so well that parents at home have even begun to feel that they are not as good for their babies and toddlers as "professionals" might be, despite the fact that these "professionals" may well be teenagers with minimal qualifications, who fell into this line of work by default.

The critical, rarely mentioned core of nursery care is that our children will be looked after in bulk - on a 1:5 or 1:8 ratio, compared to 1:1 at home. Like McDonald's fast food, we can enjoy the convenience of drive-through, ready-made, fast-parenting; through the miracle of mass production.

The rapid adoption of nursery care in the early years has been a huge social experiment; essentially a gamble taken by millions of parents that "everything will be OK". The results of that experiment are now emerging.

The first generation of babies raised in this way are now entering their teens and early 20s. Most western industrial countries are reporting record levels of young people with mental health problems.

The proportion of teenagers in the UK with behaviour problems has doubled since 1980; the proportion with anxiety and depression has risen by 70%. Across Britain, 24,000 teenagers a year are admitted to hospital after suicide attempts. The charity Childline has noted a rise in self-harm of 65% in just the past two years. The incidence of attention problems, violence problems, eating disorders, binge drinking and other addictions has also risen dramatically.

These are not the poverty-stricken children of an earlier time, lacking education, healthcare or food; affluent children are now equally represented. At the same time as this crisis has arisen, more has been learned about the foundation of mental health in the infant brain. In the past 10 years, researchers have learned that a baby's brain grows whole new structures in response to the love and affection, and caring firmness, given during its first two years of life. If this kind of intense love is not given at the right time, these areas of the brain do not grow properly and as a result there are abilities a child may never acquire.

This is perhaps the most vital message: affection feeds the brain, children raised without sufficient loving care do not fully become the human being they were meant to be.

In the 1990s, because of the critical importance of the whole question and the widespread disagreement among experts, a number of governments were persuaded that something had to be done. In the US, Britain and half a dozen other countries, very large long-term studies, bringing together teams of leading experts, were set in motion to try and establish the truth once and for all. Was nursery care harmful? And if so, under what circumstances, and why? The most comprehensive US study undertaken, the National Institute of Child Health and Development study, involved over 1,000 children from 10 diverse locations.

Results have been released progressively since it began in 1991. In the UK, the Effective Provision of Pre-School Education study (EPPE), based at the University of London, followed the lives of 3,000 children from babyhood, with extensive interviews and assessments of children's behaviour and academic performance. This study reported in 2004.

Another large-scale study of 1,200 children was carried out by acclaimed childcare expert Penelope Leach, together with the academics Kathy Sylva and Alan Stein. This study revisited babies at 10, 18, 36 and 51 months old and its results were published in late 2005. In the NICHD 2004 results, three times as many children - 17% - had noticeable behaviour problems in the over-30 daycare hours a week group, while only 6% had these problems in the under-10 hours a week cohort.

According to the researchers' report, these problems included "disobedience, being defiant, talking back to staff, getting into fights, showing cruelty, bullying or meanness to others, physically attacking other people, being explosive and showing unpredictable behaviour". These increases were small, but they were present in a large number of children. The EPPE study likewise reported that "high levels of group care before the age of three (and particularly before the age of two) were associated with higher levels of antisocial behaviour at age three".

The Leach study reported babies and toddlers in daycare to have "higher levels of aggression", and to be "more inclined to become withdrawn,compliant and sad". It concluded: "The social and emotional development of children cared for by someone other than their mothers is definitely less good." Perhaps most significantly for the researchers and parents, the quality of care - how good, stable, caring and educationally rich the settings were -had only a partial effect on the behaviour outcomes. Quality of care mattered a great deal, for reasons other than the ones being studied - it lead to better cognitive skills, and children in nurseries with more and better-trained staff were less stressed, but it could not completely remove the damage done by "too early, too much, too long".

This finding had huge ramifications because it went against everything that had previously been believed. The mantra of the 90s had been that poor outcomes were due to poor-quality nurseries.

The new studies seemed to indicate something that loving parents gave in one-to-one care that could not be substituted. Quality care was not the panacea that had been hoped for: it was still "stranger care", and in a group rather than individual setting, and this mattered to the proper development of secure and non-aggressive children.

The most significant factor of all in determining child mental health was called by researchers "maternal sensitivity"; the ability to respond warmly and sensitively to the needs of the child. This depends on the mother (or father) being sufficiently calm, supported and free from pressures, to make the child their focus, and sufficiently resourced both materially and emotionally with friends and other outlets, so that they are not depressed, lonely or overwhelmed by the demands of parenthood.

This quality relies on parents having the opportunity to get to know their baby and its nature, its needs and its means of communicating them. But even though parenting quality is more important than the amount of nursery care, they do affect each other. The studies found that one of the dangers to children was that too early, too much, and too long use of nursery care could weaken maternal sensitivity - or rather, prevent it from developing.

The first year was needed for a mother and baby to really know each other. Quality time was a lie. Hurry was the enemy of love.

There were other important findings. The negative effects of nursery care did not have a specific threshold or safety level in terms of the hours spent in care.

The more nursery care a child receives, the more the effects received, in a proportional amount. The researchers refer to this as a dose-related effect, and it is a strong pointer to a causal link. There isn't a safe level of nursery care usage for the under-threes (but at the same time, a little is better than a lot).

For anyone who knows children, this is common sense. The toddler is emotionally vulnerable, acutely aware of her social environment, who loves her, and with whom she feels safe. A toddler fears strangers, and is strongly bonded to one or two trusted adults.

A nursery environment is stressful for babies and toddlers. A baby left at a nursery will show significantly higher levels of the stress hormone cortisol than at home with its parent. The reasons for this are not hard to figure out. Babies do not have a sense of time; they cannot understand that "in eight hours' time, my mother will be back". Indeed, they are programmed to assume that if their beloved caregiver leaves them, they are in danger. Their body escalates into full panic.

A 2005 Cambridge University study reported these alarming results:"Toddlers starting at childcare experience high levels of stress in the first weeks after separating from their parents . Hormone levels doubled even in secure youngsters during the first nine days of childcare .

The levels fell over time but five months later were still significantly higher than for infants of the same age who stayed at home." Yet these children were deemed by staff to have settled down well. The conclusion is well known to psychiatrists, children who look fine on the outside can be carrying intractable levels of stress. The effects on brain development and mental health can be lifelong.

For-profit nurseries seem to be worse in a range of studies. Shortcutting on staff, nappy supplies, food quality, crowding, and cleaning are all natural tendencies when profit is the driving force. Caring takes effort and it is often unrewarded, and so easily goes into decline. Consumers want childcare to be cheap, yet cheap and quality cannot go together. There is simply no way around this reality.

The one factor agreed by all research in child development is the importance of the infant-parent bond, and how closeness of the relationship immunises a child against present and future stresses. If the only negative of long days spent in nursery is to weaken this connection, or prevent it ever growing, then this is a significant concern.

A nursery situation never has a one-to-one ratio of carer to baby - it would be prohibitively expensive. The best nurseries have one carer to three babies, and often this is one to five or six when carers are filling forms, taking a break, or performing other duties. So the child gets only a fraction of the time and energy that it really needs. Using video cameras and two-way mirrors, trained observers have studied the interaction quality between carers and children. The results are not good.

Even when childcare workers know that they are being observed as they go about their work, their interactions with children are nothing like those offered by parents. There are far fewer intimate exchanges between carers and children, and interactions are more mechanical, brusque and shorter in duration.

They are simply not as responsive. This is not the fault of the carer - in most cases they try their best to be good surrogate parents, but there are two significant factors working against them. They are not especially invested in any child, and they rarely have a long-term, stable relationship with them.

We would be deeply uneasy if carers formed the kind of affectionate special bonds with children that children actually need. Little wonder the turnover of nursery staff is running at an astonishing 30-40% per annum, caused by low pay, poor training and low status.

Of course, parents at home are also sometimes stressed, depressed, resentful, angry, unresponsive or even positively dangerous to their kids, and some kids are better off in nursery care, which at least is routine, safe and (hopefully) provides some level of warmth and stimulation. But we have to ask whether there is a better way to give parents a life, and children a life too. Why does it have to be a choice of two evils - parental loneliness and frustration, or children spending long hours in the care of strangers? Surely we can emancipate women, and yet not abandon children to indifferent care?

In those European countries which have better support for families, its a very different situation. France, Germany, Denmark do not have these problems. Low cost good quality housing is supported, jobs are secure and retraining available for parents after two or three years absence. We look like misers by comparison.

Britain spends only 0.3% of GDP on early years provision, compared with 2% in Sweden. Yet in Sweden today, there are almost no babies in daycare, a new generation of parents has opted for the excellent parental leave and job-sharing provisions in that country. In other words, a six-fold increase in expenditure would be needed to achieve a standard that Swedish parents have decided still isn't good enough.

As a result of the urging of the child development experts, the Labour government is moving tentatively in the right direction - parental leave is a hot topic now, and improvements are in the wind. Our mediaeval workplace culture also needs to shift dramatically to make parenthood possible, lest birthrates plummet beyond repair. Some parents are making choices of less affluent, more time rich lives, and finding the joys of simpler living.

Since the world actually needs us to consume less, and live more, this must be a good thing. Lets hope that the care of babies in nurseries might soon go the way of child labour in factories - and boarding school for six year olds. A horrible aberration that we finally got rid of.

Copyright (c) The Guardian 2006

baby, you deserve better


The under-3s should be at home with mum. That's why the law and the workplace must change ...

IT IS A TRUTH insufficiently acknowledged that childcare gurus are often a bit nuts. One thinks of John B. Watson, who thought that it was wrong to hug boys, Mrs Sydney Frankenburg, who insisted that young teeth would not grow if you overstimulated the brain, and Locke's theory that infants should sleep on a different surface every night. Babies have always been plagued by theorists.

So when you find a guru willing to change his mind when evidence and humanity prompt, you rejoice. For me, Steve Biddulph — one of the most popular ones in the world, with four million books sold — is the man.

For one thing, he is Australian, hence impervious to our weird class prejudices. For another, he was one of the first modern writers to admit that small boys are different from girls.

Now he risks his neck by cautioning that putting children under 3 into nurseries all day may seriously damage their development. He saw the best nurseries “struggle to meet the needs of very young children in a group setting”. The worst were “negligent, frightening and bleak — a nightmare of bewildered loneliness that was heartbreaking to watch”. He supported early nursery once; he has looked and recanted.

A year or so on from tonight's Valentine promises, you lovers could be staring hollow-eyed at one of the hairiest decisions of adult life. Especially if you are educated, aspiring professionals. Here's the baby, the loveliest thing on earth; here's the huge mortgage, here's the career. The baby is unquestionably king, but without the mortgage he won't have a home and without the career there won't be a mortgage. Even if you set aside the plight of the unsupported parent, things are unreasonably tough these days. Two jobs, in an unforgivingly ambitious and competitive world, just mean two sets of sharks and typhoons to negotiate.

But the infant needs looking after all day and does not know the meaning of compromise. If you go to work, who will step forward with love and joy? Granny is miles away (and probably far older than grannies used to be). Nannies are for the wealthiest few, unless you cut corners and opt to leave your baby alone in your house all day with someone even more inexperienced than you, who barely speaks English and who is is adrift in a new city.

A cosy neighbourhood childminder might be the answer: but in the mobile, commuting middle-class it is hard for a young working woman ignorant of babies to spot a good childminder even if she sees one. For a brisk regimented person in a suit it is far more reassuring to head for a “professional” institution with a brochure. Besides, leaving a child so soon brings on a pang of guilt that is assuaged by feeling that expensive childcare is somehow, in the ghastly league-table phrase, “adding value” to your child.

Thus, nurseries flourish and, crucially, take in ever-younger children. One in 20 British families now puts a baby in a nursery all day from the age of six months, and the trend is rising. In attacks on Steve Biddulph, commentators will no doubt brandish reports showing that children who go to nursery do better at school: but look closely and such reports invariably refer to children using nurseries between 3 and 5 years old. Compared with a baby these are great big thumping confident creatures: they can talk and tell their parents what they don't like. Smaller infants can't.

If you want to be really miserable, watch a tape of the BBC's recent undercover filming of apparently respectable nurseries where clinging baby bewilderment was routinely met with crude cries of “Ow, shurrup whingeing, Leanne!”.

We need to be subtle and precise, not to lump all pre-school children together. The first two or three years are critical: they lay down a foundation of confidence, trust and understanding of what it is to be human. A baby's best option is to be cared for by someone who loves and responds to it (even alongside distractions of siblings, housework, or part-time telework). This person does not need “qualifications”. It may be a parent or a relative, a childminder in her own home, or a paid nanny who is stable, kind and committed.

But it is very hard indeed for a nursery assistant to achieve the same level of familiar loving empathy. It is particularly hard if she is an underpaid girl of low intelligence who has never raised a child; or a foreigner working an illegal 70-hour week on a student visa and not daring to complain about her £2 a hour, lest she be thrown out. I knew one such who said she often used to fall asleep during the day; I looked up her nursery's Ofsted inspection and it passed. It was certainly making a healthy profit for its sweet-faced shark of a manageress.

There are good nurseries; there are probably babies reasonably well cared for in a group, if the staffing is consistent and skilled. But even at £7,500 a year this is a poor substitute for mother-love: Steve Biddulph is right to say so. A young baby needs a person not a place, not “affordable care” but devoted care. Perhaps not all day long, but for a good part of it.

We ought to swallow this truth and what it means for society. Employers must learn to be flexible, accept gaps in the CV and use long-distance IT creatively. It has never been easier to keep absent workers in touch with developments or to use their skills. Employers must pay the price of retaining talented, trained, and high-principled staff (opting to look after your child in its short years of greatest need is a very high-principled thing to do).

Government must stop obsessing about tickbox nursery “education” and think how to make it easier for families to organise personal babycare, not just how to squeeze them into a system where each childcare “place” means a mother out earning and paying tax.

Above all, soaring house prices must be understood as the great social evil that they are, and fought all the way. We owe those babies a couple of years each, we really do.

Copyright (c) The Times, London, 2006


Learn more about Antonella Gambotto-Burke ...
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