Nurturing Care Research Articles

Mechanisms linking height to early child development among infants and preschoolers in rural India.

Stunting has been negatively associated with children's development. We examined the range of height by testing hypotheses: (a) height is positively associated with children's development, with associations moderated by inflammation and (b) home environments characterized by nurturance and early learning opportunities is positively associated with children's development over time and attenuate associations with height. Data included 513 infants (mean age 8.6months) and 316 preschoolers (mean age 36.6months) in rural India from a randomized controlled trial of multiple micronutrient powders (MNPs). Measures included height (height-for-age z-scores based on WHO standards), inflammation (C-reactive protein concentration >5mg/L), nurturance (HOME Inventory), child development (Mullens Scales of Early Learning), and inhibitory control (preschoolers). Linear mixed effects models accounting for repeated measures, clustering, and confounders were used to assess associations between height and child development over time (infants: enrollment, 6 and 12months; preschoolers: enrollment and 8months). Moderating effects of inflammation and nurturance were tested with interaction terms. Among infants and preschoolers, height and nurturance were positively associated with all domains of child development over time, with the exception of inhibitory control. Among preschoolers, in the presence of inflammation, height was not associated with child development. Among infants, but not preschoolers, a nurturant home environment attenuated significant associations between height with fine motor and receptive language development. The mechanisms associated with children's development over time are multifactorial and include direct and indirect associations among nutrition, health, and the home environment, as supported by the Nurturing Care Framework.

What Men Do When a Baby Cries: Increasing Testosterone May Lead to Less Nurturant Care but More Environmental Vigilance

SYNOPSISInfants’ crying modulates parental behaviors, which in turn, ideally, lead to calming the infant. The mutually beneficial reciprocity between infants’ and parents’ behaviors is conserved across mammalian species. Although some studies highlight similarities in responses to infant cries across gender, other studies report differences in their behaviors and brain activity. Zeifman and colleagues in this Special Issue found that high levels of infant crying can trigger increases in testosterone in men, which is accompanied by less sensitive caregiving. Some interpret males’ lack of sensitive caregiving as neglectful, but these results could be considered as evolutionarily adaptive. Specifically, increases in testosterone levels from intense infant cries could lead to increased vigilance and alertness toward external stimuli, and thus allow males to be better equipped to protect their young.

ATTACHMENT AND BIOBEHAVIORAL CATCH-UP: A SYSTEMATIC REVIEW.

Attachment Biobehavioral Catch-up (ABC; Dozier et al., 2006) is a 10-week, in-home intervention primarily for early childhood aged children (ages 6months-2years). The ABC intervention seeks to teach parents how to provide nurturing care and engage in appropriate interactions with their children. ABC has been identified as a Level 1 evidence-based practice by the California Evidence-Based Clearinghouse for Child Welfare. However, to date, there has been no systematic review presenting the overall evidence behind ABC available in a peer-reviewed journal. The objective of this review is to address this gap by synthesizing prior literature and evidence, specifically evidence from randomized control trials (RCTs), regarding the effectiveness of the ABC intervention and to determine the contexts in which the intervention has been implemented. To complete this review, literature was searched across three bibliographic databases and relevant Web sites. Only RCTs examining child outcomes were included in the review. Using identified search procedures, 10 articles discussing RCTs which tested the efficacy of ABC were identified. Findings indicate that ABC is effective, when implemented with child-welfare-involved children, at improving emotion regulation, improving externalizing and internalizing behaviors, increasing normative developmental functioning, and attachment quality. Sample information from the 10 RCTs identified is presented as well as additional study characteristics.

Effect of a community-based integrated nurturing care interventions on early childhood development in rural China: a quasi-experimental study

Background17 million children under the age of 5 years are at elevated risk of poor development outcomes in China. We aimed to assess whether an integrated package of community-based nurturing care intervention led to a reduction in the prevalence of suspected neurodevelopmental delay to promote early development in rural China's poorest children under the age of 3 years. MethodsFrom July 1, 2014, the Integrated Early Childhood Development (IECD) programme composing comprehensive early development services was implemented in four poverty-stricken areas in China (Liping county, Songtao county, Fenxi county, and Lin county). Five nurturing care intervention components (nutrition, responsive care, child safety and social assistance, early learning support, healthy growth, and development assessment) were delivered via home visits, group sessions, ECD centres, village clinics, and mobile resource units. We evaluated the effectiveness of the intervention using a quasi-experimental design, with baseline data collection in 2013 and endline data collection in 2016, in four interventions and two control counties in which no intervention was applied (Pan county and Fangshan county). Risk factors and outcomes were assessed by use of UNICEF's Multiple Indicator Cluster Survey, Zung Self-Rating Depression Scale, and Ages & Stages Questionnaire-Chinese Edition. We applied a difference-in-differences regression approach adjusting confounding factors to estimate the effect of the intervention on the children's neurodevelopmental outcomes. We used a path analysis to examine underlying mechanisms through which the IECD intervention package could predict children's developmental health. Ethical clearance for all aspects of the study was obtained from the Ethics Review Board in Peking University. An informed consent was obtained in writing before data collection. FindingsBetween July and September, 2013, 2953 children younger than 3 years and their caregivers were interviewed at baseline. Between July and September, 2016, 2745 children younger than 3 years and their caregivers were interviewed after intervention. Prevalence of overall suspected developmental delay was reduced by 18% (from 37% at baseline to 19% after intervention) in intervention villages. This reduction significantly differed from the reduction in control villages (from 30% to 20%; adjusted odds ratio 0·69 (95% CI 0·54–0·89). Consistent findings were found across the communication, gross motor, fine motor, problem solving, and personal-social domains. Path analysis indicated that higher developmental health was partly mediated by multiple family nurturing care factors, including cognitive stimulation, positive discipline, length for age, and haemoglobin. InterpretationThe community-based integrated intervention package significantly reduced the prevalence of suspected developmental delay in children under age three in rural China. This nurturing care intervention could maybe to help improve human capital in China's poorest areas. FundingThis work was supported by Porsche (China) Motors Ltd.

The care, stimulation and nutrition of children from 0-2 in Malawi-Perspectives from caregivers; "Who's holding the baby?"

IntroductionUniversal access to quality early childhood development and care is a fundamental part of Sustainable Development Goal 4.2.1. Research from diverse settings, including that in low and middle income countries, now demonstrates the positive impact that interventions to promote play, stimulation, early communication and responsiveness can have, not just on child development, but on long term gains in education and economic growth. International agencies have recently produced the Nurturing Care Framework for Early Child Development in order to promote this and to encourage countries to move the focus from child survival to child thrival. Research on the best methods of integration of these programmes into present care practices, particularly in African settings is still very limited.MethodsWe used qualitative methods to gain an understanding of care practices (play, developmental stimulation, early communication and responsive feeding) for children 0–2 years. We conducted 18 focus groups (FGDs), six PFGDs (Participatory Research focus groups), 18 in depth interviews (IDIs) and 20 observations with caregivers in rural and urban settings of Malawi. We used a topic guide, audio-recorded the FGDs and IDIS and transcribed them in Chichewa or Yao and then into English. We coded data using an inductive approach to thematic analysis. We placed the data within a framework with the emerging major and minor themes. We conducted quality assurance for translations and coding frameworks through cross comparison of data and used respondent validation to check our results.ResultsMalawian caregivers see children’s play as a consequence of good health and wellbeing, less an interaction that a parent undertakes to promote wellbeing and learning. Non-verbal communication and responsiveness with infants is clearly present and caregivers have many one-on-one interactions with young infants. Furthermore, many caregivers have good knowledge of feeding recommendations but cannot always follow these due to constraints on money. When children become mobile (toddlers), play is an activity done more often between children or with other caregivers such as siblings or grandparents.Community members consider that caring for children from 0–2 years is a woman’s domain. Despite this, both men and women acknowledge the importance of maternal wellbeing in enabling good care of children. The present socioeconomic situation of most families in our study means that income generation and food security come first. Many mothers spend most of their time managing the responsibilities of daily living and have limited time to dedicate to children’s play, responsiveness and communication with their children.DiscussionProgrammes promoted as part of the Nurturing Care Framework which provide advice on developmental stimulation, play, early communication and responsive feeding should ensure that topics within these programmes are culturally appropriate for the setting. Furthermore, programmes must not be an added burden to parents but be supportive to parents managing many responsibilities of daily living. Multi-sectorial approaches where both men and women are provided with knowledge but are also supported through programmes which address family finances, safe spaces for children whilst families are working, and family mental health and relationships may enable programmes to work more effectively.

Resources for nurturing childcare practices in urban and rural settings: Findings from the Colombia 2010 Demographic and Health Survey.

The health and development potential of young children is dependent on nurturing care (NC) provided by primary caregivers. NC encompasses attention to nutrition; symptom management; early learning, attachment, and socialization; and security and safety. Despite the importance of NC to child health and development, the measurement and study of NC are neglected. This has become a point of major concern in the public health field in low- and middle-income countries (LMICs) such as Colombia where many families are hard pressed for childcare resources. The aims of this study were therefore to (a) create age-specific NC summary indexes (0-5, 6-11, and 12-23months) suitable for research in LMICs and (2) examine the relationship of NC to maternal resources. 2010 Colombia Demographic and Health Survey data were obtained from mothers and their children ages 0-5months (n=1,357); 6-11months (n=1,623); and 12-23months (n=3,006). Age-specific NC indexes were created including information on child feeding, immunization, hygiene, response to illness symptoms, and psychosocial care. Independent variables included mother's education level and household assets, and enrolment in a government child development programme. Regression analyses with NC as the outcome variable were conducted with urban and rural subsamples in the 3 age groups. Among rural children, NC was significantly higher with greater household assets, maternal decision latitude, and development programme participation, with variation by child age. Among urban children, higher maternal education and white-collar occupation also predicted higher NC, with some variation by age. It is feasible to measure age-specific NC in survey research, and NC is related to maternal resources. Age and urban-rural differences in how NC is related to social factors are observed. The findings support the importance of subgroup analysis in the study of NC in LMICs such as Colombia.

Translation of evidence to practice to promote early childhood development programs.

The 2018 special issue of Annals of the New York Academy of Sciences on implementation research and practice for early childhood development brings together emerging evidence on implementing effective nurturing care programs, addressing issues of quality and scale. Translating evidence to practice requires addressing the barriers perceived by policy makers, which have been highlighted in the published literature. Here, I describe how UNICEF and other global partners are addressing these barriers.

The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36⁻59 Months in Honduras.

Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36–59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011–2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD.

Wages of Nurturant and Reproductive Care Workers: Individual and Job Characteristics, Occupational Closure, and Wage-Equalizing Institutions

Despite the work’s social importance, nurturant and reproductive care workers earn less than others with comparable human capital and work demands. We explore three broad questions related to pay for care work. First, we examine nurturant and reproductive care penalties together to investigate what mechanisms produce the lower wages for these workers. Second, we examine how occupational closure through education credentials and licensing requirements creates varying returns to care work. Finally, we explore the roles of wage equalizing institutions—labor unions and government sector care provision—in reducing wage disparities associated with care work. Using the 1979-2012 waves of the National Longitudinal Survey of Youth (NLSY) and fixed-effects regression models, we find that selection on stable factors and human capital differences explain much of the lower wages for reproductive workers, but none of the low wages of nurturant workers. However, compared to non-care workers, college-educated nurturant care workers receive lower returns to work experience, suggesting limitations in how much learning can increase efficiency in care work, given the labor intensive, face-to-face nature of much of it. Occupational closure matters: care jobs with the highest educational and licensing requirements pay a wage bonus, while less closed care occupations incur a penalty. Wage equalizing institutions have both floor and ceiling effects on care worker wages that mitigate care penalties for selected workers: women reproductive workers and women in low-education/high-licensing occupations. More consistently, ceiling effects of these institutions lower the wages of otherwise higher paid care workers: nurturant and high-education/high licensing occupations.

PENS Position Statement on Transgender Youth

THE PEDIATRIC ENDOCRINOLOGY Nursing Society (PENS) is committed to advancing the art and science of pediatric endocrinology nursing. PENS members specialize in the nursing care of children with endocrine conditions, including those who identify as transgender or gender non-conforming. The World Professional Association for Transgender Health (WPATH, 2012, p. 5) defines transgender identity as “discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics).” Transgender youth access endocrine care for blocking of pubertal hormones and eventual cross hormone therapy to assist with their transition. Therefore, PENS nurses are in a unique position to advocate for gender inclusive, culturally sensitive care of transgender or gender non-conforming children and adolescents as their allies in encouraging education and policy development for all communities, including schools, clubs, sports, home, clinics, and institutions. Nurses are respected in society as both nurturing and competent health care practitioners who follow a code of ethics. The International Council of Nurses (2012, p. 1) code of ethics states explicitly that nurses must not discriminate because “...inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, color, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status.” Nurses’ attitudes toward people who identify as

A History of Stepfamilies in Early America by Lisa Wilson

Reviewed by: A History of Stepfamilies in Early America by Lisa Wilson Mary Beth Sievens (bio) KEY WORDS Family structure, Stepfamilies, Marriage, Children, Estate A History of Stepfamilies in Early America. By Lisa Wilson. (Chapel Hill: The University of North Carolina Press, 2014. Pp. xiv, 155 + illustrations, appendix. Paper, $29.95.) In A History of Stepfamilies in Early America, Lisa Wilson examines a common family structure that has been rather neglected in historical scholarship. Wilson is particularly concerned with examining “the interplay between lived reality and cultural expectations about stepfamily life” (6). She focuses on late eighteenth- and early nineteenth-century New England because of an abundance of scholarship on the region’s family life, excellent archival and genealogical sources, and its stable demographics and high literacy rates. Wilson reviews the laws that governed stepfamily members’ rights and responsibilities as well as literary sources describing stepfamily life, placing them alongside examples of the experiences of actual stepfamilies. Wilson demonstrates the very real effects that laws and negative stereotypes had on stepfamily life; however, in the process she leaves a number of questions unanswered and does not completely explain how, or even whether, changes in cultural expectations regarding stepfamilies affected lived experience. Wilson argues that, when children were involved, the decision to remarry was difficult for both widows and widowers. The legal nuances of coverture meant that, for widows, remarriage placed their deceased husbands’ property under the control of their new husbands, a situation that easily could jeopardize their children’s inheritances. Widowers with children also struggled with the decision to remarry. On the one hand, [End Page 815] heightened cultural expectations related to the development of the sentimental family ideal pressured widowers to remarry in order to give their children the loving, nurturing, and pious care early Americans believed only women could provide. On the other hand, long-standing negative cultural stereotypes about stepmothers’ cruelty and preference for their own children over those of their new husbands became even more potent when contrasted with the image of the sentimental mother wholly devoted to the care of her (“natural”) children. Legal realities and this negative cultural milieu worked against carefree decisions to remarry, and Wilson provides real-life examples of men and women who agonized over the effects that remarriage would have on their children. That so many widows and widowers did remarry is testimony to the difficulties of providing for a family without a spouse and, of course, to the vagaries of the human heart. Wilson maintains that within stepfamilies negative cultural stereotypes encouraged children to compare their stepmothers and their “natural” mothers, with stepmothers inevitably found wanting. An examination of the correspondence and papers of three stepfamilies demonstrates the very real role that these negative stereotypes played in shaping stepchildren’s relationships with their stepmothers. Stepchildren openly acknowledged struggling with negative ideas about stepmothers, while new stepmothers worried that they would not be acceptable to their stepchildren. In one of the families Wilson examines, domestic harmony and love prevailed in the face of negative stereotypes; in another, different children had very different relationships with their stepmother, some close and loving, others cool and aloof. The final family demonstrated the complete rejection of a stepmother by her stepchildren. This broad range of experience is not particularly surprising, and Wilson does a very good job of bringing these stepfamilies’ experiences and struggles to life. However, while these families’ different experiences are wonderfully described, there is no analysis of why their experiences differed. Admittedly, this type of analysis is difficult to accomplish with a limited pool of examples; however, opportunities for a closer consideration of the reasons for these families’ differences do exist. Wilson hints at, but does not explore, issues related to the age and gender of stepchildren and to the socioeconomic compatibility (or lack thereof) between stepmother and stepchildren as determinants of stepfamily experience. More careful analysis of such characteristics would better explain why some families [End Page 816] successfully negotiated the treacheries of stepfamily life while others did not. Wilson argues that cultural expectations surrounding stepmothers began to improve at the turn of the nineteenth century. Tracing developments in children’s and didactic literature, Wilson claims that the growing...

Prematüre Bebeklerin Ev Ortamlarındaki Uyaranların Değerlendirilmesi

Objective: Premature babies may encounter problems at different levels in language, cognitive, social-emotional, relation and motor development. The developmental status of these infants is not only associated with their birth weight, gestational age, perinatal risks and health status but also with individualized nurturing care and appropriate stimulation provided at home, socioeconomic status of the family and maternal education level in the literature. It is suggested to support the development of high-risk premature infants by providing appropriate stimulation in the first years of life because of the rapid development of the brain in the early years. Premature infants are at high risk for developmental difficulties and hence it is important to question the stimulations provided in the home environment during the follow up visits. The purpose of this study was to determine the responsive and stimulating home environment provided by the families and highlight the need for developmental support for premature infants. Material and Methods: Premature babies (gestational age ≤ 32 weeks) and their families who presented at the Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Developmental Pediatrics Unit for the first time for developmental evaluation were asked questions to determine the stimuli provided at home. Appropriate and inappropriate stimuli and the frequency and factors affecting them were assessed.

A Beaked and Feathered God

A Beaked and Feathered God

Differential Methylation of Genes in the Medial Prefrontal Cortex of Developing and Adult Rats Following Exposure to Maltreatment or Nurturing Care During Infancy

Quality of maternal care in infancy is an important contributing factor in the development of behavior and psychopathology. One way maternal care could affect behavioral trajectories is through environmentally induced epigenetic alterations within brain regions known to play prominent roles in cognition, emotion regulation, and stress responsivity. Whereas such research has largely focused on the hippocampus or hypothalamus, the prefrontal cortex (PFC) has only just begun to receive attention. The current study was designed to determine whether exposure to maltreatment or nurturing care is associated with differential methylation of candidate gene loci (bdnf and reelin) within the medial PFC (mPFC) of developing and adult rats. Using a within-litter design, infant male and female rats were exposed to an adverse or nurturing caregiving environment outside their home cage for 30 min per day during the first postnatal week. Additional littermates remained with their biological caregiver within the home cage during the manipulations. We observed that infant rats subjected to caregiver maltreatment emitted more audible and ultrasonic vocalizations than littermates subjected to nurturing care either within or outside of the home cage. While we found no maltreatment-induced changes in bdnf DNA methylation present in infancy, sex-specific alterations were present in the mPFC of adolescents and adults that had been exposed to maltreatment. Furthermore, while maltreated females showed differences in reelin DNA methylation that were transient, males exposed to maltreatment and both males and females exposed to nurturing care outside the home cage showed differences in reelin methylation that emerged by adulthood. Our results demonstrate the ability of infant-caregiver interactions to epigenetically mark genes known to play a prominent role in cognition and psychiatric disorders within the mPFC. Furthermore, our data indicate the remarkable complexity of alterations that can occur, with both transient and later emerging DNA methylation differences that could shape developmental trajectories and underlie gender differences in outcomes.

Will health visiting survive?

W hen I met district nurses and health visitors last week in Edinburgh, there was much discussion about our plans for the integration of acute and community health services and social care. There were questions and comments about the pace of change, the implications of such fundamental change for frontline staff and, most importantly, what it will mean for patients—how will it really improve services and outcomes of care? How will we ensure robust clinical governance and professional accountability? There were also questions about money and how health budgets would be ‘protected’ against the need to subsidise the rising demand for social care. It was a very interesting and stimulating session. I did my best of course to share our thinking and our progress in terms of agreeing how we will deal with such issues and to share my hopes about such a fundamental shift in the way we deliver our services, but one question stood out for me: ‘Will health visiting survive?’ This was as much a general question as one linked to health and social care integration. It certainly was not a question I was expecting, but the answer was easy: ‘Yes it must.’ Health visiting celebrated its 150th birthday last year and has as much to do now as it did when the profession was born, in terms of helping to improve the health of the population. The need for significant support for mothers and babies, as well as the more general public health agenda, means there is plenty for health visitors to do. We know so much more now about the importance of nurturing and good health care in the early years of life (as well as pre–birth) and we need to be applying it in practice for every child. Attempts not so long ago at national change in Scotland to review community nursing instigated more upset and concern among frontline practitioners than successful progress towards developing a confident community nursing workforce ready to face such challenges as integration. I hope that is well behind us and we can all move on. The policy context in Scotland does clearly hold a place for health visitors. This is evident in Modernising Nursing in the Community (www.mnic.nes.scot.nhs.uk), Health for All Children (‘Hall 4’) (Scottish Government, 2005 and 2011), Getting it Right for Every Child (GIRFEC) (2008) and The Early Years Framework (2009). The introduction of models of care developed and tested elsewhere, such as the Family Nurse Partnership (FNP), provides excellent evidence-based care and support to a specific group of clients—but not to all. Such programmes as FNP were not meant for all women and their families. The strength of health visiting is that it was and is meant for all women and their families, as part of the provision of universal services that underpins the NHS. Our current challenge across the UK is that, to Melanie Hornett Nurse Director NHS Lothian Health Board continue to provide a health visiting service to all, we do need to find different ways to deliver and sustain it. The demands placed on the service by health inequalities, the needs of vulnerable children and child protection issues, as well as the impact of parental substance misuse, to name but a few, continue to rise. Added to this, across Lothian we have a growing population. Routine work around parental support, developmental checks and immunisation is also considerable. The demands of the workload, especially around child protection, are often cited to me as reasons why it is hard to recruit and retain health visitors in certain areas. We know that the best care for children and their families comes from child-focused teams working together across professional and organisational boundaries and this brings me back to where I started—integration.

Enhancing Attachment Organization Among Maltreated Children: Results of a Randomized Clinical Trial

Young children who have experienced early adversity are at risk for developing disorganized attachments. The efficacy of Attachment and Biobehavioral Catch-up (ABC), an intervention targeting nurturing care among parents identified as being at risk for neglecting their young children, was evaluated through a randomized clinical trial. Attachment quality was assessed in the Strange Situation for 120 children between 11.7 and 31.9 months of age (M = 19.1, SD = 5.5). Children in the ABC intervention showed significantly lower rates of disorganized attachment (32%) and higher rates of secure attachment (52%) relative to the control intervention (57% and 33%, respectively). These results support the efficacy of the ABC intervention in enhancing attachment quality among parents at high risk for maltreatment.

Early educational foundations for the development of civic responsibility: An African experience

An innovative curriculum designed to foster the development of social responsibility among pre-adolescent children was introduced at a rural Zambian primary school. The curriculum invoked Child-to-Child principles focusing on health education, advancing a synthesis of Western psychological theories and African cultural traditions. The teacher sought to democratize the educational process through cooperative learning in mixed-gender, mixed-social-class, and mixed-ability study groups. Learners engaged in community service activities and contributed to the nurturant care of younger children. Young adults interviewed seventeen years after completing the program recalled their experience and reflected on how it had promoted their personal agency, cooperative disposition, and civic responsibility in early adulthood.

Bringing Multiples Home

Bringing multiples home differs from bringing home a single newborn. Mothers have experienced a more challenging pregnancy; a multiples pregnancy often results in a preterm delivery. As a result, bringing multiples home requires different discharge planning, preparation, and parent education to ensure each multiple receives the nurturing and physical care needed to thrive.

The pathways from mother's love to baby's future

Together with genetic factors, early-life experience governs the expression and function of stress-related genes throughout life. This, in turn, contributes to either resilience or vulnerability to depression and to aging-related cognitive decline. In humans and animal models, both the quality and quantity of early-life maternal care has been shown to be a predominant signal triggering bi-directional and enduring changes in expression profiles of genes including glucocorticoids and corticotropin releasing factor (CRH; hypothalamic and hippocampal), associated with the development of resilient or vulnerable phenotypes. However, many crucial questions remain unresolved. For examples, how is the maternal-derived signal transmitted to specific neuronal populations where enduring (likely epigenetic) regulation of gene expression takes place? What is the nature of this information? In other words, how do neurons know to ‘turn on’ epigenetic machinery? What are the direct functional consequences of altered gene expression? This review describes the voyage of recurrent bursts of sensory input from the mother (‘mother's love’) to CRH-expressing hypothalamic neurons that govern the magnitude of the response to stress. In addition, the acute and enduring effects of both nurturing and fragmented maternal care on the structure, cellular signaling and function of specific hippocampal and hypothalamic neurons are discussed. The evolving understanding of the processes initiated by the early life experience of ‘mother's love’ suggest novel molecular targets for prevention and therapy of stress-related affective and cognitive disorders.

Reproducing Labor Inequalities

The author uses census data to assess the consequences of two alternative theoretical formulations of care work for understanding the intersections of gender, race, and economic inequalities in paid care. The nurturance conceptualization focuses on care as relationship while the reproductive labor framework includes both relational and nonrelational jobs that maintain and reproduce the labor force. An empirical application of both models to the labor market shows that placing increasing theoretical emphasis on nurturant care privileges the experiences of white women and excludes large numbers of very-low-wage workers from consideration.