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Stanford University School of Medicine

Investing in nurturing care during early childhood pays off, new studies find

fifth-birthday-cakeAround the world, there's a sea change underway in children's health: Early childhood mortality has been cut in half. Children born today are much more likely to live to see their fifth birthdays than kids born 25 years ago.

But just surviving early life isn't enough. Kids need to thrive, and many don't.

In fact, at least 250 million children -- 43 percent of all the young kids living in low- and middle-income countries -- are now at risk of not meeting their full developmental potential, according to a new series of scientific studies published in The Lancet. Stunting and extreme poverty limit these children's physical, intellectual and emotional growth. In their first 1,000 days of life, their bodies and brains don't get the nurturing care -- the healthy food, basic medical care, safe and stable homes, and early childhood education -- that would give them the best shot at becoming productive adults.

Stanford's Gary Darmstadt, MD, played a big role in developing the series and is senior author of its third paper. In a press release issued by The Lancet, he explains why countries around the world should put more resources into early child development:

Our economic analysis shows that the cost of inaction is huge, and in many countries far exceeds their spending on health and education. Supporting nurturing care is a wise investment, and one that should be prioritised in all countries.

Darmstadt and his fellow scientists found that children who experience growth stunting and extreme poverty earn 25 percent less per year as adults than those who receive nurturing care during early childhood. In low-and middle-income countries, the lost income is up to twice the amount those countries spend on health, as news reports on the series of papers explain.

The researchers also demonstrated that their estimate of 250 million children at risk for poor development is, if anything, low. In 15 countries, they studied the additional impacts on early childhood development of having a mother with a low education level (i.e. who completed primary school) and of being maltreated, such as with severe physical punishment. When these factors are taken into account, more than 60 percent of the countries' children are at risk.

The Lancet series gives several recommendations for evidence-based methods to help young children thrive. For instance, countries can promote breastfeeding, ensure a livable minimum wage, guarantee paid parental leave and provide all children with free preschool. These up-front investments in early life are economically worthwhile in the long run.

Darmstadt is in Washington, DC, today to celebrate the launch of the series, and in the next few weeks he'll be traveling to Cote d'Ivoire, China and Brazil to share the message that investing in early childhood pays off. When we spoke recently, Darmstadt told me, "I think this is really an idea whose time has come."

Previously: Ending preventable stillbirth: A Q&A with Stanford global-health expert Gary Darmstadt, Countdown to Childx: Global health expert Gary Darmstadt on improving newborn survival and Helping newborns through song
Photo by Katherine

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