Commentary: Early Development

My brother and sister-in-law are expecting their first baby – and my children’s first cousin – any day now. The whole family is anxiously anticipating this new addition, and lots of preparations are underway. A beautiful nursery, car seat, strollers, breastfeeding equipment, toys, books, and most importantly lots of love and attention are waiting for my niece. This impending joy also has made me think more about the questions I often hear from new parents – not just about the physical care of their infants, but how they can best stimulate their babies’ intellectual and emotional development. When considering the continually emerging knowledge and understanding of the affects of early toxic stress on long-term health, and the protective effects of strong relationships and attachments (Pediatrics 2012;129:e224), this is an area that we as pediatric providers should feel very comfortable giving advice and anticipatory guidance about.

I suspect we all have our own approach to answering this type of question, but here are a few things (some of which I have written about before) that I have come to believe are among the most important to emphasis.

First, and most importantly, loving positive relationships and time together are more important than things. I take care of families with lots of financial resources, and families with almost none, families with very stable homes and families with very little stability. There is no question that resources and family stability make things easier, but also no question in my mind that a strong loving attachment to a consistent adult caregiver builds a tremendous amount of resilience and confidence in a child no matter how much stuff you have. I find that this advice helps families – all of whom want to do the very best for their children – put things into perspective.

Children learn by doing things in three dimensions. Touching things, looking at real objects, and experiencing the world around them helps stimulate learning and encourages curiosity. Again, this does not require significant resources – a pile of pots and pans or a simple set of blocks can be better toys than the fanciest gift.

It is important to read together. Lots of evidence tells us that having books in the house and reading together daily is just good for kids.

It is important to play outside. Kids need to run, roll around in the dirt, look at leaves and spend time away from screens. Richard Louv wrote a wonderful book entitled "Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder" (Chapel Hill, N.C.: Algonquin Books, 2008) for anyone who is interested in reading more.

Structure is good. Children who grow up generally knowing what to expect from their days feel more secure and are better able to trust and explore their environment.

As pediatricians we can play an important role in helping to support families so that every baby has a chance to grow up like my niece. The opportunity we have to teach ways of supporting development from the very earliest days of a baby’s life is unique and has a huge impact, and as research continues to show, can have effects long after children age into adulthood.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center and the George Washington University Medical Center, Washington. She is chair of the American Academy of Pediatrics Committee on Residency Scholarships and president of the District of Columbia chapter of the American Academy of Pediatrics. She said she had no relevant financial disclosures.

My brother and sister-in-law are expecting their first baby – and my children’s first cousin – any day now. The whole family is anxiously anticipating this new addition, and lots of preparations are underway. A beautiful nursery, car seat, strollers, breastfeeding equipment, toys, books, and most importantly lots of love and attention are waiting for my niece. This impending joy also has made me think more about the questions I often hear from new parents – not just about the physical care of their infants, but how they can best stimulate their babies’ intellectual and emotional development. When considering the continually emerging knowledge and understanding of the affects of early toxic stress on long-term health, and the protective effects of strong relationships and attachments (Pediatrics 2012;129:e224), this is an area that we as pediatric providers should feel very comfortable giving advice and anticipatory guidance about.

I suspect we all have our own approach to answering this type of question, but here are a few things (some of which I have written about before) that I have come to believe are among the most important to emphasis.

First, and most importantly, loving positive relationships and time together are more important than things. I take care of families with lots of financial resources, and families with almost none, families with very stable homes and families with very little stability. There is no question that resources and family stability make things easier, but also no question in my mind that a strong loving attachment to a consistent adult caregiver builds a tremendous amount of resilience and confidence in a child no matter how much stuff you have. I find that this advice helps families – all of whom want to do the very best for their children – put things into perspective.

Children learn by doing things in three dimensions. Touching things, looking at real objects, and experiencing the world around them helps stimulate learning and encourages curiosity. Again, this does not require significant resources – a pile of pots and pans or a simple set of blocks can be better toys than the fanciest gift.

It is important to read together. Lots of evidence tells us that having books in the house and reading together daily is just good for kids.

It is important to play outside. Kids need to run, roll around in the dirt, look at leaves and spend time away from screens. Richard Louv wrote a wonderful book entitled "Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder" (Chapel Hill, N.C.: Algonquin Books, 2008) for anyone who is interested in reading more.

Structure is good. Children who grow up generally knowing what to expect from their days feel more secure and are better able to trust and explore their environment.

As pediatricians we can play an important role in helping to support families so that every baby has a chance to grow up like my niece. The opportunity we have to teach ways of supporting development from the very earliest days of a baby’s life is unique and has a huge impact, and as research continues to show, can have effects long after children age into adulthood.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center and the George Washington University Medical Center, Washington. She is chair of the American Academy of Pediatrics Committee on Residency Scholarships and president of the District of Columbia chapter of the American Academy of Pediatrics. She said she had no relevant financial disclosures.

My brother and sister-in-law are expecting their first baby – and my children’s first cousin – any day now. The whole family is anxiously anticipating this new addition, and lots of preparations are underway. A beautiful nursery, car seat, strollers, breastfeeding equipment, toys, books, and most importantly lots of love and attention are waiting for my niece. This impending joy also has made me think more about the questions I often hear from new parents – not just about the physical care of their infants, but how they can best stimulate their babies’ intellectual and emotional development. When considering the continually emerging knowledge and understanding of the affects of early toxic stress on long-term health, and the protective effects of strong relationships and attachments (Pediatrics 2012;129:e224), this is an area that we as pediatric providers should feel very comfortable giving advice and anticipatory guidance about.

I suspect we all have our own approach to answering this type of question, but here are a few things (some of which I have written about before) that I have come to believe are among the most important to emphasis.

First, and most importantly, loving positive relationships and time together are more important than things. I take care of families with lots of financial resources, and families with almost none, families with very stable homes and families with very little stability. There is no question that resources and family stability make things easier, but also no question in my mind that a strong loving attachment to a consistent adult caregiver builds a tremendous amount of resilience and confidence in a child no matter how much stuff you have. I find that this advice helps families – all of whom want to do the very best for their children – put things into perspective.

Children learn by doing things in three dimensions. Touching things, looking at real objects, and experiencing the world around them helps stimulate learning and encourages curiosity. Again, this does not require significant resources – a pile of pots and pans or a simple set of blocks can be better toys than the fanciest gift.

It is important to read together. Lots of evidence tells us that having books in the house and reading together daily is just good for kids.

It is important to play outside. Kids need to run, roll around in the dirt, look at leaves and spend time away from screens. Richard Louv wrote a wonderful book entitled "Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder" (Chapel Hill, N.C.: Algonquin Books, 2008) for anyone who is interested in reading more.

Structure is good. Children who grow up generally knowing what to expect from their days feel more secure and are better able to trust and explore their environment.

As pediatricians we can play an important role in helping to support families so that every baby has a chance to grow up like my niece. The opportunity we have to teach ways of supporting development from the very earliest days of a baby’s life is unique and has a huge impact, and as research continues to show, can have effects long after children age into adulthood.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center and the George Washington University Medical Center, Washington. She is chair of the American Academy of Pediatrics Committee on Residency Scholarships and president of the District of Columbia chapter of the American Academy of Pediatrics. She said she had no relevant financial disclosures.