HEALTH, SAFETY, AND NUTRITION FOR THE

YOUNG CHILD

1 CHAPTER ONE: CHILDREN’S WELL-BEING

AND EARLY CHILDHOOD EDUCATION
Kelly McKown

CHILDREN’S WELL-BEING AND EARLY CHILDHOOD

EDUCATION
A culture of wellness exists when staff and child health and safety are valued, supported, and promoted through
health & wellness programs, policies, and environment. [1]

Learning Objectives

Objectives

At the end of this chapter, you should be able to:

 Explain why health and well-being in early childhood is so important.

 Describe qualities and benefits of high-quality early care and education programs.
 Outline what the book will be addressing in regards to safety, health, and nutrition.
 Discuss what licensing is and its role in keeping children safe and healthy.
 Compare and contrast Rule 2 (family child care) and Rule 3 (child care centers) licensing requirements.

Introduction

Evidence shows that experiences in childhood are extremely important for a child’s healthy development and
lifelong learning. How a child develops during this time affects future cognitive, social, emotional, language, and
physical development, which in turn influences school readiness and later success in life. Research on a number
of adult health and medical conditions points to pre-disease pathways that have their beginnings in early and
middle childhood.
 Figure 1.1 – What happens when children are young can have a lifelong effect. [2]

During early childhood, the human brain grows to 90 percent of its adult size by age 3. Early childhood represents
the period when young children reach developmental milestones that include:

 Emotional regulation and attachment

 Language development
 Cognitive development
 Physical development (motor skills)

All of these milestones can be significantly delayed when young children experience inadequate caregiving,
environmental stressors, and other negative risk factors. These stressors and factors can affect the brain and may
seriously compromise a child’s physical, social-emotional, and cognitive growth and development.

More than any other developmental periods, childhood sets the stage for:

 School success
 Health literacy
 Self-discipline
 The ability to make good decisions about risky situations
 Eating habits
 Conflict negotiation and healthy relationships with family and friends[3]

Understanding Childhood Health Concerns

Although young children are typically healthy, it is during this time that they are at risk for conditions such as:

 Developmental and behavioral disorders

 Child maltreatment
 Asthma and other chronic conditions
 Obesity
 Dental caries (cavities)
 Unintentional injuries
 Figure 1.2 – Young children may develop dental caries (cavities). [4]

While typically nonfatal, these conditions affect children, their education, their relationships with others, and the
health and well-being of the adolescents and adults they will become.[5]

Emerging Issues in Childhood Health

The keys to understanding childhood health are recognizing the important roles these periods play in adult health
and well-being and focusing on conditions and illnesses that can seriously limit children’s abilities to learn, grow,
play, and become healthy adults.

Prevention efforts in early and middle childhood can have lasting benefits. Emerging issues in early and middle
childhood include implementing and evaluating multidisciplinary public health interventions that address social
determinants of health by:

 Fostering knowledgeable and nurturing families, parents, and caregivers

 Creating supportive and safe environments in home, schools, and communities
 Increasing access to high-quality health care[6]

Early Childhood Development and Education

Early childhood, particularly the first 5 years of life, impacts long–term social, cognitive, emotional, and physical
development. Healthy development in early childhood helps prepare children for the educational experiences of
kindergarten and beyond. Early childhood development and education opportunities are affected by various
environmental and social factors, including:

 Early life stress

 Socioeconomic status
 Relationships with parents and caregivers
 Access to early education programs

Early life stress and adverse events can have a lasting impact on the mental and physical health of children.
Specifically, early life stress can contribute to developmental delays and poor health outcomes in the
future. Stressors such as physical abuse, family instability, unsafe neighborhoods, and poverty can cause children
to have inadequate coping skills, difficulty regulating emotions, and reduced social functioning compared to other
children their age.

Additionally, exposure to environmental hazards, such as lead in the home, can negatively affect a child’s health
and cause cognitive developmental delays. Research shows that lead exposure disproportionately affects children
from minority and low–income households and can adversely affect their readiness for school.
The socioeconomic status of young children’s families and communities also significantly affects their
educational outcomes. Specifically, poverty has been shown to negatively influence the academic achievement
of young children. Research shows that, in their later years, children from disadvantaged backgrounds are more
likely to need special education, repeat grades, and drop out of high school. Children from communities with
higher socioeconomic status and more resources experience safer and more supportive environments and better
early education programs.

The Effects of Poverty on Education

“Despite being one of the most developed countries in the world, the United States has one of
the highest rates of childhood poverty globally.”[7] “Poverty has a particularly adverse effect
on the academic outcomes of children, especially during early childhood.”[8] Research has
shown that children from families in poverty enter school with a readiness gap. Contributions
to this gap include:
· Poor physical development and health (due to poor nutrition and lack of access to medical
care)

· Challenges with concentration, memory, attentiveness, curiosity, and motivation[9] due

to the chronic stress of living in poverty

· Greater risk for behavioral and emotional problems

· Exposure to environmental hazards (such as lead paint) and violence in their

communities.

Two additional things that are important to note:

· This gap disproportionately affects Black and Latinx children.

· Families experiencing poverty have challenges finding affordable, high-quality early care
and education programs and are often in districts with under-resourced schools. [10]

Early childhood programs are a critical outlet for fostering the mental and physical development of young
children. According to the Center on the Development Child at Harvard University’s A Science-Based Framework
for Early Childhood Policy,

“ The principal elements that have consistently produced positive impacts include:

 highly skilled teachers;

 small class sizes and high adult-to-child ratios;
 age-appropriate curricula and stimulating materials in a safe physical setting;
 a language-rich environment;
 warm, responsive interactions between staff and children; and
 high and consistent levels of child participation.”[11]
The National Association for the Education for Young Children says that high quality programs:

 Create caring communities of learners in which children develop relationships with each and the teachers
and each child and family are included.
 Teach to support children’s development and learning by being intentional with the environmental design,
materials, and activities and by providing positive guidance for children’s behavior.
 Have developmentally appropriate curriculum that helps children learn and grow that sets challenging, yet
achievable goals for children, balances adult instruction and group activities with play and child-chosen
experiences, provides enough time for deep engagement, and is based on the children’s interests, abilities,
and knowledge.
 Regularly assesses children’s development and learning to inform their environmental design, curriculum,
and interactions with children and their families.
 Is founded on partnerships with families in which families are respected and valued, share their goals and
concerns, are encouraged to participate, and with clear communication (in a family’s home language
whenever possible).[12]

And you can check out the checklist 15 Must-Haves for All Child Care Programs published by The
Administration for Children and Families Office of Child Care in Appendix A. What does high-quality preschool
look like? Watch this 6-minute video from NPR Ed to see one example.

Early childhood development and education programs can also help reduce educational gaps. For example, Head
Start is a federally funded early childhood program that provides comprehensive services for children from low–
income families. Head Start aims to improve health outcomes, increase learning and social skills, and close the
gap in readiness to learn for children from low–income families and at-risk children. Enrolling children in full-
day kindergarten after the completion of preschool has also been shown to improve academic achievement.

Furthermore, extended early childhood programs for children up to 3rd grade, also referred to as booster
programs, can provide comprehensive educational, health, and social services to complement standard early
childhood and kindergarten programs. These programs help sustain and bolster early developmental and academic
gains. Characteristic of such programs include:

 Low student-teacher ratio

 Teacher training
 Creation of school-family partnerships
 School meals
 Provision of transportation to and from school
 Health care services and referrals
 Home visitation
 Supportive social services
Figure 1.3 Early Head Start’s “Framework for Programs Serving Infants and Toddlers and their Families.” You
can see how a compilation of services leads to children’s well-being regardless of the age of the child. [13]

Quality education in elementary school is necessary to reinforce early childhood interventions and prevent their
positive effects from fading over time. Research also shows that school quality has an impact on both the short–
and long–term educational attainment of children, as well as on their health. For example, children who enroll in
low–quality schools with limited health resources, safety concerns, and low teacher support are more likely to
have poorer physical and mental health.

The developmental and educational opportunities that children have access to in their early years have a lasting
impact on their health as adults. The Carolina Abecedarian Project found that the children in the study who
participated in a high–quality and comprehensive early childhood education program, including health care and
nutritional components, were in better health than those who did not. The study found that, at age 21, the people
who participated in the comprehensive early education program exhibited fewer risky health behaviors—for
example, they were less likely to binge drink alcohol, smoke cigarettes, and use illegal drugs. This group also
self–reported better health and had a lower number of deaths.

Furthermore, by their mid–30s the children who participated in the comprehensive early childhood development
and education program had a lower risk for heart disease and associated risk factors, including obesity, high blood
pressure, elevated blood sugar, and high cholesterol. These studies show that quality early childhood development
and education programs can play a key role in reducing risky health behaviors and preventing or delaying the
onset of chronic disease in adulthood. We will look at what high quality programming looks like at the end of the
chapter.

Early childhood development and education are key determinants of future health and well–being. Addressing
the disparities in access to early childhood development and education opportunities can greatly bolster young
children’s future health outcomes.

Additional research is needed to increase the evidence base for what can successfully impact the effects of
childhood development and education on health outcomes and disparities. This additional evidence will facilitate
public health efforts to address early childhood development and education as social determinants of health.[14]
Importance of Considering Holistic Development

Early childhood education (ECE) is not a singular concept, but rather a holistic concept that focuses on several
aspects of a child’s development, including their cognitive, social, emotional, moral, spiritual, and physical well-
being (American Academy of Pediatrics 2012; Chisholm 2004; Tinajero & Loizillon 2012). According to
Shonkoff, et al. (2011), debates about early childhood education often focus on education and the enhancement
of children’s cognitive skills and later academic progress. However, these authors stress the importance of
viewing children in a holistic manner as part of a bigger system. In this manner, early childhood education
becomes a vehicle for enhancing the physical, cognitive, mental, social and economic well-being of individuals
and the societies in which they live. Early care and education programs should enhance multiple interrelated
dimensions of a child’s life; including health and safety, nutrition, emotional well-being, and social
competence.[15]

Focus on Wellness

Rather than waiting for health issues to arise, families and early childhood education programs should focus on
supporting children’s wellness. “Wellness describes the entirety of one’s physical, emotional, and social health;
this includes all aspects of functioning in the world (physiological, intellectual, social, and spiritual), as well as
subjective feelings of well-being. A child who is doing well frequently experiences joy, delight, and wonder, is
secure and safe in his/her family and community, and is continually expanding and deepening his/her engagement
with the world around him/her.”[16]

Figure 1.4 – Well children can engage in their environment and with others. [17]

Wellness is an active process. It requires awareness and directed, thoughtful attention to the choices we make.
Early care and education programs can play a critical role in helping children, families and staff commit to and
implement healthy lifestyle choices that promote both physical and mental well-being. The two, in fact, are closely
linked. Our feelings, thoughts, and behaviors directly impact our physical health. Similarly, our physical health
status has a direct impact on our feelings, thoughts, and behaviors.[18]

We must also support children’s mental well-being and help them navigate everyday stress and adversity as well
as trauma and significant sources of stress. The American Psychological Association shares that “[b]uilding
resilience — the ability to adapt well to adversity, trauma, tragedy, threats or even significant sources of stress —
can help our children manage stress and feelings of anxiety and uncertainty.”[19]

It is important that children are in an environment that keeps them physically and emotionally safe and healthy
and provides sound nutrition. As an early educator, providing these requires attention, planning, and intention.
Introduction to Safety, Health, and Nutrition

Safety

Children are curious and eager to learn. They depend on their caregivers to keep them safe by making sure that
nothing within a child’s reach can harm them. Injuries are a serious health risk to young children. But most injuries
are predictable and preventable.[20]

Figure 1.5 – This playground protects children from falls and from the sun. But it fails to protect children by
being enclosed with a fence and gate. [21]

ECE programs can prevent risks and unnecessary harm to children by committing to a culture of safety. A culture
of safety prioritizes safety at all levels. It encourages programs to learn from past problems and prevent them in
the future.[22] Programs should not assume that nothing will ever go wrong. In fact, they should plan that
something is going to go wrong. And their goal is to make it as hard as possible for things to go wrong.[23]

Health

“Health is more than merely the absence of disease—it is an evolving human resource that helps children and
adults adapt to the challenges of everyday life, resist infections, cope with adversity, feel a sense of personal well-
being, and interact with their surroundings in ways that promote successful development.”[24]

Figure 1.6 – These children are learning about handwashing to prevent the spread of illness. [25]
As mentioned at the beginning of the chapter, research is showing that many adult health issues, such as high
blood pressure, heart disease, and diabetes, are linked to what happens during early childhood (and even
prenatally!). We also know that during early childhood there are biological systems that are more sensitive to
environmental factors (such as child maltreatment, malnutrition, and recurring issues to infectious disease).[26]

It is vital for children and their families to have support for children’s physical, oral, and mental health. This
happens through promoting health and protection from illness.

Nutrition

Healthy eating and being active are essential to a child’s well-being. Children who are under- or over-nourished
are at risk for chronic health problems.[27] Early childhood is an important time for developing healthy habits for
life. Children’s bodies grow and develop in ways that affect the way they think, eat, and behave.[28]

A healthy diet not only affects growth, but also immunity, intellectual capabilities, and emotional well-being.
Families and educators must ensure that children receive an adequate amount of needed nutrients to provide a
strong foundation for the rest of their lives.[29]

Figure 1.7 – This teacher and child are setting the table for a meal. [30]

Regulations

The Florida Department of Children and Families (DCF) ensures that early learning centers follow minimum
requirements for care of young children. You can read the laws and requirements here:
https://www.myflfamilies.com/services/child-family/child-care/child-care-laws-and-requirements

While licensing regulations ensure that children stay safe and healthy, high quality care goes even further to
provide the best start for young children. One reason that programs choose to become NAEYC accredited is to
document the quality of care and education they provide children and families they serve. There are other
processes and assessments that programs may use to ensure high quality, as well. In Minnesota, that includes the
Parent Aware Quality Rating and Improvement System. This is a voluntary program that helps families find
quality child care and early education and helps early learning programs improve their practices in order to prepare
the children for school and life.
Pause to Reflect

As you progress through this book and course, what connections can you make about how being
knowledgeable about health, safety, and nutrition will support early childhood educators in both
following licensing and other applicable regulations and ensuring they provide high quality care
for young children and their families?

Summary

Early childhood is a critical time in development. Many outcomes, both positive and negative, have their
beginnings in these years. It is vital that children’s health and safety be protected. High-quality early care and
education programs can play a valuable role in improving outcomes for children.