Abstract

Sixty percent of women (35% of mothers of children less than 18 years of age and 45% of mothers with preschool-aged children) in the United States work outside the home either of necessity or by choice. The pediatrician, who has an important role in helping such women find the best way of dealing with their multiple and demanding roles as workers, wives, and mothers, is often asked to address some of the questions posed below. 1. Is my working harmful to my child? The answer to this question depends upon (a) the provision of a safe, caring environment for the child; and (b) the mother's satisfaction in her outside work, the support and help of her family, and her vitality at the end of the day to nurture her children. 2. How do I evaluate a substitute care-giving situation? In addition to safety, sanitation, and the provision of proper nutrition, the kind of care giver to whom a young infant or young child is entrusted is the overriding consideration. This person must be warm, caring, responsible, and able to provide the child the stimulation of new learning experiences. In all cases, parents should talk frequently with the care giver about the child-rearing practices they desire, especially if the substitute mother is inexperienced or comes from a different sociocultural background. Although the needs of each child in a group setting vary with his or her age and personality, a ratio of one adult to three infants less than 2 years of age is advised, with the desired ratio increasing to 1 to 4 or 1 to 5 for older children.

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