What policies, parenting practices help babies and toddlers thrive?

The little girl, 5, is thriving and she’s well on her way to being a confident, creative child. Right now, she’s practicing an affirmation her mom taught her: “I am brave. I am kind. I am strong. I am beautiful. I am smart. I am Lucy Llewellyn,” she announces.

Her little sister Ruby, 20 months old, watches intently and tries to say the words, too, ending with her own name. When they’re done, they’ll scamper off to play or sing or build something.

The girls don’t know that Ruby’s in the thick of perhaps life’s most exciting developmental period — 0 to 3 — with ramifications for all that is to come. Or that their parents, Todd and Ashley Llewellyn, of Spanish Fork, Utah, are giving them a great start by paying attention to the details of their early years: making sure they’re well-nourished physically and emotionally, providing abundant creative outlets, reading with them, sheltering them and showering them with love.

Those are vital gifts to a child from parents. But Cynthia Osborne, professor of early childhood education and policy at Vanderbilt University and director of the school’s Prenatal-to-3 Policy Impact Center, believes that they’re not enough. Society needs to provide gifts, too, including family-friendly policies that help children flourish, she said.

Policies that help families — especially those who are struggling — are simultaneously generous and self-serving if you believe as experts including Osborne do that children are a societal gift and will pay back any investment.

When they grow up, today’s babies will shape the country’s economy, entrepreneurial landscape and competitiveness. They will form the safety net that cushions their parents’ generation and drives a future workforce and new policies.

But to do it well, they first must flourish.

Kristin Murphy, Deseret News

Working moms and child care subsidies

The Annie E. Casey Foundation says every child needs food, health care and safe and stable housing — a bottom floor on which a child’s well-being can be built. Then you build up with other protections, including policies proven to aid families with very young kids, especially those with economic and other challenges.

The Vanderbilt center’s “United States Prenatal-to-3 State Policy Roadmap” lists goals, with strategies and policies to reach them. Then it tracks what states are doing.

“We know that these early years predict lifelong health and well-being. So getting it right really matters,” Osborne told the Deseret News.

Prenatal to 3 is “the most rapid and sensitive period of development and it sets the foundation for long-term health and well-being,” the report says. “All children deserve the opportunity to be born healthy and raised in nurturing, stimulating, stable and secure care environments with limited exposure to adversity.”

At that very young age, children begin to develop their sense of self and a place in the world. They grow confident or fearful, depending on circumstances. They move from being cradled to crawling to standing and walking, developing motor skills and personality and patterns that will stretch and grow as they do. Relationships take shape that will help shape those to follow.

Researchers have long known parents need some skills, knowledge and resources if babies are going to do well from the start. Prenatal care helps babies be born healthy and helps parents get ready. The center’s list includes policies and strategies for states to reach well-child goals.

As Lucy did, Ruby’s getting her start without many of the challenges children in families with few resources have. Mom Ashley was a first grade teacher before she quit to raise her daughters. Dad Todd will soon take over the family plumbing business, a stable career. When they need a babysitter, family helps, but usually Ashley is able to take care of her girls. Many families have very different situations than the Llewellyns.

The Bureau of Labor Services this year said that as of 2019, just under 6 in 10 women are employed, the share of working moms growing. Several reports estimate a third of working women are working moms of school-age children. For some, work outside the home is an economic necessity and family-related policies likely impact them the most.

The center says that, to help rather than hinder child development, policies should combine broad-based economic and family support. The researchers call for access to affordable quality health insurance and a liveable wage ($10 is their minimum wage benchmark), a state earned income tax credit, paid family leave and fewer administrative hurdles for families to receive help if they need it.

Different states have tackled some of the evidence-based strategies the center applauds, including child care subsidies to keep little ones safe while parents work or go to school, comprehensive screening and connection to needed programs, prenatal care, proven home-visiting programs, early Head Start and early intervention services.

Four states have implemented versions of all five policies: California, Washington, D.C., Maryland and New Jersey. Nineteen states have at least three of them. The details vary, but they’re robust enough to make a difference.

Child care is emerging as both contentious and important, because if families don’t have a safe, affordable, high-quality place to care for their children when they can’t, parents may not be able to work to better provide for the kids.

“We’re paying a lot of attention to implementations because just having a policy on the books if no one’s using it, if it’s not generous enough, if it’s difficult to access, may not be as effective. You may not be getting the returns that you would be expecting or making the impact on well-being,” said Osborne.

Last year, the center created a baseline on which to measure how states improve or lose ground. They’re less interested in issuing grades than in helping states do a better job supporting children and parents, Osborne said. The researchers hope states will see how their neighbors are doing and learn from each other.

Kristin Murphy, Deseret News

Strong child development goals

“More and more, we see that folks understand how important the 0 to 3 years are, but there hasn’t been a lot of guidance as to what you should actually do if you want to improve outcomes,” said Osborne.

Besides pushing for optimal child development, the center’s report prioritizes healthy births, access to services, parents’ ability to work, the physical and emotional health of parents and strong parent-child bonds.

What children need crosses income levels, though policies are more likely to target the socioeconomic disadvantages found disproportionately in children of color and among those of lower socioeconomic status. Those households are less apt to have stable income or paid time off when a family member is sick, said Osborne.

While higher-income households may share many of the challenges, like having a child with a developmental delay or a parent who needs substance abuse or mental health treatment, folks with better resources are more able to get help for themselves.

But needs can climb higher up the income ladder than many realize.

Some middle-income families are stuck between earning too much and not being able to afford needed services, so policies like a state earned income tax credit help, Osborne said. That same squeeze broadens the appeal for programs like universal preschool, she said.

Other policies, like paid leave, help a wide income range of workers. And the bonding benefit of time with a very young child is universal.

Kristin Murphy, Deseret News

How states can help families

Some states have independently taken steps to help families, said Osborne. Washington and Oregon have put substantial investment into child care, expanding eligibility for subsidies. That also increases the workforce size.

Ten states have passed paid family leave for all working families, though only six have already implemented it.

Ten states have a minimum wage of at least $15 coming within the next five years.

“It remains to be seen what the implications are of that,” said Osborne. “Most of the research has been done on minimum wages around $10-12 an hour.”

Boosting fertility

America’s birthrate, like that of most of the world, has been falling, which could lead to ever-smaller new generations and economic stagnation. Many experts believe factors like the cost of child care contribute to people having fewer babies. So child care subsidies are drawing broad scrutiny because they might help.

Financial challenges may convince couples to forego or at least put off having kids. That’s a shared concern for policymakers with very different ideas about how and when to help families.

A birthrate that dips too low is not good for a country, creating long-term challenges that may dog generations.

“It’s hard to imagine at this point how do you have children, pay for child care, buy a home, pay for college,” Osborne said. “Children are incredibly expensive.”

But delaying or foregoing parenthood has substantial societal consequences.

The 2021 American Family Survey, a nationally representative poll by YouGov for the Deseret News and BYU’s Center for the Study of Elections and Democracy, found policy could have an impact. Asked about a child benefit from the government, 17% of those in what’s considered prime childbearing years said a benefit would increase their interest in having a child — or more children.

At the time of the survey, the child tax credit had been expanded temporarily as part of pandemic relief, half about to be paid monthly. Half of respondents thought it was a good idea, compared to 29% opposed.

The expansion was temporary and has ended.

Osborne thinks policymakers know lots of families need help and they do believe children are an investment. But with tight budgets and other needs, that’s something they can postpone.

She said investing in early intervention programs helps prepare kids to learn when they get to school. Costs for special education or having a child repeat a grade will both drop, Investing in parents’ ability to work if they choose puts more tax revenue into the system and spending into the economy. And when parents can provide well for their children, fewer need government aid.

“What I wish is that our policymakers could understand that there are both immediate and long-term returns to investing in young children and their parents in terms of cognitive development, in learning and socioemotional development and physical health. And those benefits last a lifetime,” Osborne said.