Dietary guidelines provide advice on what to eat to different subsets of the population but often do not take into account the "how" to eat. Responsive feeding is a key dimension of responsive parenting involving reciprocity between the child and caregiver during the feeding process and is characterized by caregiver guidance and recognition of the child's cues of hunger and satiety. Evidence indicates that providing responsive feeding guidance to mothers on how to recognize and respond appropriately to children's hunger and satiety cues can lead to improved feeding practices and weight status and developmental outcomes among infants and young children. In addition, early and nurturing exposures to foods with different tastes and textures and positive role modelling help children to learn to eat healthy foods. The importance of improving caregiver's responsive feeding behaviours to ensure the adequate introduction of complementary foods is becoming increasing recognized, but responsive feeding principles have not been taken into account in a comprehensive way in the development of dietary guidelines. The incorporation of all responsive feeding principles into dietary guidelines has a strong potential to enhance their impact on early childhood development outcomes for infants and young children but will require adaptation to the different contexts across countries to ensure that they are culturally sensitive and grounded in a deep understanding of the types of foods and other resources available to diverse communities.
Rafael Pérez‐Escamilla, Sofía Segura‐Pérez, Victoria Hall Morán
The nurturing care framework (NCF) for early childhood development (ECD) launched at the 2018 World Health Assembly opens a range of opportunities and challenges for child neurodisability professionals. The United Nations Convention on the Rights of the Child and Convention on the Rights of People with Disabilities frame these pathways for collaboration and progress. This overview of the NCF and its contexts in inclusive ECD identifies avenues for innovation and collaboration in harmony with the field's clinical, scientific, and advocacy agendas. One avenue involves enhancing the alignment between health systems and human rights. A second avenue involves neurodisability professionals engaging with nurturing care as leaders, partners, and implementers. WHAT THIS PAPER ADDS: Participation and leadership by neurodisability professionals can enhance quality and impact. A rights-based framework that includes young children with disabilities and their families is widely encouraged.
The next 1,000 days of a child's life (spanning from the age of two to five years) offer a crucial opportunity to build on early gains and sustain or improve trajectories of healthy development. This period is vital for cognitive, motor, and socio-emotional growth. Consequently, it emphasizes nurturing care, which refers to the conditions established by public policies, programs, and services that enable caregivers and communities to ensure good health, adequate nutrition, responsive caregiving, opportunities for early learning, and safety and security. While Early Childcare and Development (ECD) interventions are not new in the Philippines, the next 1,000 days underscore the importance of continuity of care, emphasizing that the responsibility for ECD extends beyond parent-child relationships and the silos of the health and nutrition sectors. However, research involving disaggregated data during this period is limited among low- to middle-income countries, including the Philippines. Additionally, efforts to promote development in the next 1,000 days are often inadequate or not effectively translated into policies. This report aims to provide a baseline assessment of relevant outcomes during this critical period through the lens of the nurturing care framework, using population-level data covering children under the age of five. This assessment will guide the formulation of policy recommendations to enhance and build on these efforts, maximizing this golden opportunity for early child development.
BACKGROUND: Parenting health literacy is essential for effective caregiving, yet its impact on nurturing care ability remains insufficiently studied. This study aimed to investigate the association between parenting health literacy and nurturing care ability, with a focus on the mediating role of parenting stress. METHODS: A cross-sectional survey was conducted among 3623 caregivers of children aged 0-6 years in Yiwu, Zhejiang Province, China. Standardised instruments were used to assess parenting health literacy, parenting stress and nurturing care ability. Mediation analysis quantified the contribution of parenting stress to the association between health literacy and nurturing care ability, and domain-specific mediation effects were examined. RESULTS: Higher parenting health literacy was significantly associated with lower parenting stress (β=-0.12, p<0.001) and greater nurturing care ability (β=0.10, p<0.001). Parenting stress mediated 33.68% of the association between parenting health literacy and nurturing care ability. Domain-specific analyses revealed stronger mediation for parenting style (42.31%), play experience ability (37.81%) and responsive care (37.26%) compared with other domains. CONCLUSIONS: Parenting health literacy improves nurturing care ability both directly and indirectly by reducing parenting stress, with particularly pronounced effects in emotionally demanding domains. Interventions to enhance parenting outcomes should integrate health literacy promotion with stress management strategies.
Background: Despite increased global attention to early childhood development, children under 5 in low- and middle-income countries face heightened risks of poor developmental outcomes. In Indonesia, where innovative approaches to nurturing care are needed, video-based interventions show promise.Purpose: This study aimed to elevate maternal competence in parenting and contribute to the holistic development of children aged 0-3 years through video-based nurturing care education.Method: Non-equivalent quasi-experimental design with pre-post-test control groups was employed. This study used a consecutive sampling technique on 89 mothers with children 0-3 years old (intervention group = 40 and control group = 49). The intervention group was given health education using videos via a WhatsApp link, and the control group was given leaflets directly. Data was collected from May to August 2022, four weeks before the intervention (pre-test) and two weeks after the video and leaflets were given (post-test). The instrument was modified from the Knowledge, Attitude, and Practice (KAP) questionnaire developed by UNICEF. The effect of education was analyzed using Wilcoxon and independent t-test.Results: The group that received the intervention showed a notable and positive influence on their knowledge, attitudes, and practices (KAP levels) in contrast to the control group. This suggests the video-based intervention effectively enhanced participants' understanding, attitudes, and caregiving practices.Conclusion: The research emphasizes the positive outcomes of video-based nurturing care intervention for mothers with children aged 0-3 years. The intervention significantly improved maternal attitudes toward parenting, caregiving behaviors, and overall child development. These results emphasize the significance of employing video interventions to encourage effective nurturing care practices.
Fitri Haryanti, Lely Lusmilasari, Ema Madyaningrum et al.
We examine empirical and conceptual considerations related to the role of nurturing care for protecting human capital formation in the context of climate change. Climate change is a pressing global challenge. Heatwaves, wildfires, storms, and floods are becoming more frequent and severe, and their direct impact and aftermath can have long-lasting negative effects on employment, education, healthcare, and access to essential services. Children are particularly vulnerable to these harms due to their developmental immaturity and limited capacity to mitigate and avoid risks [1,2]. Consequently, parents and other adult primary caregivers - such as grandparents, relatives, and foster parents (hereafter "caregivers") - provide the primary buffer between climate hazards and adverse developmental outcomes. They do this through nurturing care, defined as the provision of stable environments that promote children's health and nutrition, safety and security, opportunities for learning, and emotionally supportive relationships [3]. Despite the central role of nurturing care for children's life outcomes, it rarely appears in climate change research and policy discourse.
BACKGROUND: Understanding donor, government and out-of-pocket funding for early child development (ECD) is important for tracking progress. We aimed to estimate a baseline for the WHO, UNICEF and World Bank Nurturing Care Framework (NCF) with a special focus on childhood disability. METHODS: To estimate development assistance spending, the Organisation for Economic Cooperation and Development's Creditor Reporting System (OECD-CRS) database was searched for 2007-2016, using key words derived from domains of the NCF (good health, nutrition and growth, responsive caregiving, security and safety, and early learning), plus disability. Associated funds were analysed by domain, donor, recipient and region. Trends of ECD/NCF were compared with reproductive, maternal, newborn and child health (RMNCH) disbursements. To assess domestic or out-of-pocket expenditure for ECD, we searched electronic databases of indexed and grey literature. RESULTS: US$79.1 billion of development assistance were disbursed, mostly for health and nutrition (US$61.9 billion, 78% of total) and least for disability (US$0.7 billion, 2% of total). US$2.3 per child per year were disbursed for non-health ECD activities. Total development assistance for ECD increased by 121% between 2007 and 2016, an average increase of 8.3% annually. Per child disbursements increased more in Africa and Asia, while minimally in Latin America and the Caribbean and Oceania. We could not find comparable sources for domestic funding and out-of-pocket expenditure. CONCLUSIONS: Estimated international donor disbursements for ECD remain small compared with RMNCH. Limitations include inconsistent donor terminology in OECD data. Increased investment will be required in the poorest countries and for childhood disability to ensure that progress is equitable.
Leonardo Arregocés-Castillo, Robert C Hughes, Kate Mackinnon Milner et al.
It is thought that supporting the early childhood period, which is of critical importance in terms of cognitive, social, emotional and physical development in children, with the components of the developmental care scope will increase the peace and welfare levels of future generations.In addition to the applications carried out in this context in our country, there is also a need for applications that we need to add to our health practice.The purpose of the review is to talk about the scope of nurturing care and nurturing care practices in our country in the light of current information and to offer suggestions to further develop the scope.
Nurturing care interventions postulated on strengthening caregiver-child relationships have proven to be effective for improving early childhood development outcomes in low- and middle-income countries. Hence, a scale-up of the interventions has been recommended with an emphasis on the health sector given the contact with families in the critical first 3 years of life. However, an effective scale-up of an integrated intervention through healthcare requires a theory of change approach elucidating pathways of sustainable change. From this viewpoint, I reflect on my experience of scaling the intervention in a private pediatric care setting. I realized that buy-in from the health sector required realization of benefits to include health outcomes framed as the potential to improve the quality of life and the process of recovery; sustainable behavior change required a culture that promoted nurturing care highlighting the role of leadership; subsequently improving the experience of frontline staff and at an individual level, this could be achieved through the provision of supportive supervision-rooted in a framework of compassion. The lessons learned are shared to be considered for future integration efforts.
A comprehensive evidence-based framework is needed to guide policies and programmes that enable children and adolescents to accrue the human capital required to meet the Sustainable Development Goals (SDGs). This paper proposes a comprehensive, multisectoral, multilevel life-course conceptualisation of human capital development by building on the Nurturing Care Framework (NCF), originally developed for the foundational period of growth and development through the age 3 years. Nurturing care (NC) comprises stable environments that promote children's health and nutrition, protect from threats, and provide opportunities for learning and responsive, emotionally supportive and developmentally enriching relationships. NC is fostered by families, communities, services, national policies and beyond. The principles apply across the life course, endorse equity and human rights, and promote long-term human capital. This paper presents an evidence-based argument for the extension of the NCF from preconception through adolescence (0-20 years), organised into six developmental periods: preconception/prenatal, newborn/birth, infancy/toddlerhood, preschool, middle childhood and adolescence. The proposed framework advances human capital within each developmental period by promoting resilience and adaptive developmental trajectories while mitigating negative consequences of adversities.Attaining the SDGs depends on strengthening human capital formation, extending throughout childhood and adolescence and supported by NC. Embedded in enabling laws, policies and services, the dynamic NCF components can mitigate adversities, enhance resilience and promote the well-being of marginalised groups. The life-course extension of the NCF is strategically positioned to enhance human capital, to attain the SDGs and to ensure that children or adolescents are not left behind in reaching their developmental potential.
Maureen M. Black, Jere Richard Behrman, Bernadette M. E. G. Daelmans et al.
