The Pediatrician's Role in Setting Standards of Day Care for Children

Abstract

The goal of pediatric practice is to promote optimal health, growth, and development of infants, children, and adolescents, and pediatric training is aimed at this goal. Thus, pediatrics has long been involved in establishing optimal health practices affecting nutrition, supervision of the environment, preventive health services, and the promotion of practices that optimally enhance social and emotional development. These generic areas of expertise apply in unique ways to children cared for in groups, especially very young children. A large body of research has been produced by pediatricians and other health professionals that addresses the specific health needs of infants and children in group care. Studies have especially addressed the spread and control of infectious disease and the prevention of injury in groupcare settings. Pediatric research, often in collaboration with psychologists, educators, and other professionals, has also addressed issues pertinent to optimal cognitive stimulation and behavioral management of the developing child, as well as the prevention of abusive practices. Thus, much of what constitutes the body of pediatric knowledge is crucial to the optimal care of young children in group settings. In the traditional practice of pediatrics, pediatricians apply their expertise to the care of individual children in the context of the family. The unwritten contract for pediatric care is between the parents and the pediatrician on behalf of the child. However, the school, day-care, or other community-based programs become an extension of the family, and the pediatrician relates to those community programs on behalf of children and their families. What the pediatrician recommends on behalf of the individual child becomes a recommendation to the program as well as to the child's family.