What kind of a future would you like to see for your child? The way parents answer this question may determine whether or not the child survives. When parents see a future for their child, they will do their best to provide the child with the care required for survival, even in circumstances where very little food is available. However, if parents are hesitant or cannot give a response to the question, the child may not survive.

The latest research on the relationship between health, nutrition and stimulation argues convincingly that an adequate food supply is not enough to assure a child's survival, neither is access to micro-nutrients, neither is education, nor absence of disease. Children's growth and development is fostered when all these variables are present, within a caring environment.

Given economic conditions worldwide, children will increasingly be born into poverty and situations which threaten their chances for optimal human growth and development. Statistics are likely to worsen as the numbers living in urban areas increase, which they will. It is estimated that a further expansion of urban slum and squatter settlements is inevitable.

Survival and healthy development cannot be achieved without significant attention to young children, from their conception through age six. The basis for good physical health and cognitive functioning in later years must be established during the early years. The dependence and rapid growth typical of infancy and early childhood make children vulnerable to a variety of health, nutritional, psychosocial and other environmental conditions. Those living in poverty are particularly at risk of poor physical and psychosocial development.

In terms of physical, intellectual, emotional and social well being, the period from conception to age 6 is the key to subsequent growth, development and ultimate productivity. Children have different needs, depending on where they are within this stage. The youngest children are completely dependent on adults. As they become toddlers, environmental cleanliness, encouragement of eating and vigilance in terms of the child's safety are of utmost importance. The pre-school child is more self-reliant and may have developed skills to obtain food for themselves and protect themselves a little from pathogens in the environment.

A wide variety of inputs (tabulated below) are required to support children's growth and development. An important thing to note is that all the inputs require someone to interact with the child. Very young children are not capable of obtaining what they need on their own. The importance of adult-child interaction is underscored by the latest research which addresses specifically the relationship between nutrition, care and development.

Inputs Required for Children’s Growth and Development

protection from physical danger

adequate nutrition

adequate health care

adults with whom to form attachments

adults who can understand and respond to their signals

things to look at, touch, hear, smell, and taste

opportunities to explore the world

appropriate language stimulation

support in acquiring new motor, language and thinking skills

a chance to develop some independence

help in learning how to control their own behavior

opportunities to begin to learn to care for themselves daily opportunities to play with a variety of objects

opportunities to develop fine motor skills encouragement of language through talking, reading, singing

activities which will develop a positive sense of mastery opportunities to learn cooperation, helping, sharing

experimentation with pre-writing and pre-reading skills

The Importance of Care

A child’s requirements for care includes much more than keeping the child safe and free from harm. Care giving behaviors include breastfeeding; providing emotional security and reducing the child's stress; providing shelter, clothing, feeding, bathing, supervision of the child's toilet; preventing and attending to illness; nurturing and showing affection, interaction and stimulation; playing and socializing; protecting from exposure to pathogens; and providing a relatively safe environment for exploration (Zeitlin 1991, Myers 1992). A second set of care giving behaviors includes the use of resources outside the family, including curative and preventative health clinics, prenatal care, the use of traditional healers, and members of the extended family network (Engle 1992). All of these behaviors are a part of supporting the development of young children.

In the context of feeding, caring practices include frequent physical contact, being consistently responsive to the child's needs and showing affection to the child. Care also includes active feeding which means being aware of how much the child is eating, offering the child a second helping, assisting the child in the use of a utensil instead of expecting complete self-feeding, and offering praise for eating (Engle 1992).

The studies of feeding are but one example of current research that indicates the powerful effect of the interaction between the child and the environment on growth and development. Another example comes from longitudinal studies of children growing up in poverty. In Hawaii, Werner (1982) identified children who were able to thrive even though the conditions under which they were raised suggested they would be malnourished and not develop well. She termed those children that did well resilient.

In her research, Werner sought to identify what makes some children more resilient. She concluded, as have others, that the differences between children who thrive and those who falter are determined by the type of interaction that occurs between the child and the environment. The child's ability to thrive is greatly enhanced by the amount of affective stimulation and the kind of care the child receives. This clearly supports the contention that it is not enough to merely provide food. The child needs food and care.