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Is daycare stressful for toddlers?

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      Numerous studies report a link between daycare centers and stress. The more time young children spend in childcare facilities, the more likely they are to develop abnormal stress hormone profiles. What's normal? Typically, the body produces high levels of the stress hormone cortisol in the early morning.

      Regarding cognitive development, studies have found negative effects, no significant links, and positive daycare effects. Research has shown that daycare hinders the quality of parent-child relations, does not hinder it, that the adverse effects are small and transitory, or intermittent.

      A new study published in the Journal of Epidemiology & Community Health concludes that "high-quality centre-based childcare may be linked to lower levels of emotional symptoms." Basically, being around children their age, under the supervision of professionals is really good for kids' emotional and prosocial ...

      Toddlerhood is a special and exciting time when a vast amount of physical, emotional, and cognitive growth occurs. With all the changes happening in their little bodies and minds, toddlers are often sensitive to the world around them and are prone to feeling stress. Stressors can be as universal as the normal developmental stage of separation anxiety or unintentional exposure to the evening news. 

      Starting daycare can be a stressful time for both babies and parents alike. Some babies will adapt quickly, while others will cry every morning for many weeks. Does starting daycare have any impact on a child's brain? It can. This is especially true in children younger than 36 months (3 years of age). This is why research recommends that the best time to begin daycare or preschool is 3 years of age. Elevated cortisol levels in children that occur frequently can alter the brain's architecture. However, the reality is that most parents must place their children in daycare much earlier than at 3 years of age.

      First, a Little Science on Stress and the Brain.

      Researchers measure stress in children by collecting saliva samples since the stress hormone cortisol (a glucocorticoid hormone) is found in saliva. However, when it comes to stress in children, we can't rely on behaviour alone since some children will internalize stress.

      Levels of cortisol naturally fluctuate throughout a 24-hour day. For example, cortisol levels are highest in the morning when we wake up and are the lowest in the evening (the spike helps you wake up, and the decrease allows you to fall asleep). This is the rhythm our body develops as of childhood. Therefore, if a child is introduced to high levels of stress throughout the day, it will influence their natural cortisol levels. This is what can be damaging in the long run. 

      Internal or external stresses will cause a child's brain to activate the HPA axis (Hypothalamic-Pituitary-Adrenocortical), which regulates stress and emotions. When there is a stressful event, the HPA increases levels of cortisol. The HPA axis is closely linked to the hippocampus, which is the part of the brain involved in learning and memory. Chronic and severe (due to emotional neglect, abuse, witnessing violence) stress levels can alter the hippocampus, thus causing memory issues. 

      Studies have repeatedly shown that cortisol levels are higher in children who spend the day in daycare compared to being at home in daycare settings. Not only because they are separated from their parents for such long periods (if possible, try to reduce the number of hours a child under 3 spends at daycare), but because being in peer groups at such a young age is very demanding on them due to frequent emotional arousal in their environment (other kids yelling, lots of movement and noise etc.). The key to reducing stress in daycare is the bond your child will create with their caregiver. The stronger this attachment or bond is with their caregiver, the more it will help your child reduce their levels of stress.

      Causes of Stress for Children in Child Care

      A large variety of situations can cause children to feel stress in child care. Child care providers should keep an eye out for these situations to identify stress in children and help them cope with the stress as quickly as possible. The following are examples of stressful situations children in child care may experience:

      • changes in routines
      • a new child care setting
      • conflict with peers or bullying
      • lack of sleep
      • overcrowded child care settings
      • a new sibling
      • loss of a loved one  
      • conflict at home
      • deployment of a family member

      How should we interpret the drop in mid-morning cortisol levels? The researchers raise three possibilities:

      • The results may suggest there may be some adaptation to parental separation. The results found that there were decreases in the midmorning levels of cortisol, suggesting that the early weeks were representative of stress upon leaving the parent, which does seem to attenuate as the weeks progress.
      • In line with other research is that children (even infants) "anticipate" daycare days and have higher HPA axis activity overnight, resulting in periods of hypoactivation the following morning. This means that the anticipation of daycare causes stress. By the next morning, their brains have gone into a period of hypoactivation to compensate for the higher levels of adrenocortical activity overnight. (Total aside: What's interesting about this is that this idea of cortical "anticipation" might negate one of the criticisms of the research looking at cortisol levels during extinction sleep training. Namely, the infant in that study showed high levels of cortisol just before the onset of the bedtime ritual on all days tested, even though mom was present with the child, and many speculated that this stress was due to the new environment, despite most research suggesting new environments with mom don't result in this change. My speculation had been the anticipatory nature of bedtime that had been problematic for the families leading them to the sleep clinic in the first place. Anyway, I just thought I'd share that tidbit here though it has no bearing on daycare.)
      • The third possibility is that the sleep changes that often go along with transitions to daycares result in a shifting of the cortisol levels at the midmorning assessment if they have been waking earlier the longer they are in daycare. This presupposes that the patterns of sleep-wake times shifted significantly over the 10 weeks, which was not measured in this particular study, but remains a possibility.

      Most importantly, how does this fit with other research on daycare? It seems to fit quite nicely in with what we already know: Namely, that daycare results in changes to cortisol levels, specifically changes in line with possible stress responses. This adds to the body of research by demonstrating that these changes occur during transition regardless of age, though the magnitude and effect differ by age. Perhaps most importantly, this study failed to assess the quality of care, which raises questions about the applicability to all daycares.

      This is critical as other new research on a daycare published recently was used to debunk the idea of any long-term externalizing problems. However, this research is difficult to extrapolate or compare to the bulk of behavioural research cited earlier for one big reason: The daycare in question was in Norway, not the United States, where the bulk of the behavioural research has been done. Scandinavian countries are renowned for having excellent, high-quality daycare for all children, which is lacking in the USA and elsewhere. In line with this, many of the effects seen in daycare are eliminated or at least minimized when the daycare is deemed "high-quality" (and why I believe we need to push for high-quality daycare on a larger scale for families who need it) as mentioned previously. This is important if we view cortisol levels as a flag for possible stress that would impact long-term development, particularly social development if the stress is peer-related.

      Interestingly, even in the Norwegian study, there were differences in levels of aggression based on time spent in daycare at 2 years of age, but rather these effects had faded by 4 years of age. This could suggest that daycare is stressful for children but that higher-quality daycare helps children adapt and cope with this stress in a manner that is conducive to longer-term well-being. Conversely, in lower-quality care, the stress is left to build up with little support from caregivers, leading to a higher risk of longer-term problems based on time spent in this lower-quality care and child temperament.

      Creating a Supportive Culture in Child Care

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      What does a supportive culture look like at a child care centre?

      • Teachers are trained on how to handle their stress and how to manage a classroom. It doesn't do any good to pretend that only bad teachers get frustrated. Very good and experienced teachers are not immune to stress. Acknowledge this and give teachers the skills to cope. Teachers can learn techniques to manage their classrooms positively.
      • Teachers get regular breaks throughout the day. Especially important to break away from the kids, not in the classroom. Naptime is not usually a break for teachers, especially if some of the kids don't sleep. Getting out of the classroom to breathe and regroup is essential.
      • Teachers are encouraged to ask for help. Sometimes the only way to calm down is to leave the situation, but a teacher often cannot leave the room without a replacement. Administrators can give a teacher an unscheduled break if they need it and do not make the teacher feel bad about it.
      • Teachers are looking out for each other. If a teacher notices a co-worker getting frustrated, they aren't afraid to step in and help or call someone to give that co-worker a break. Not to get someone in trouble, but to keep the co-worker and kids safe.
      • Administrators or extra staff are available during stressful situations in the classroom. Often transitions are the most challenging times (getting ready to go outside, transitioning from lunch to nap, etc.). In addition to providing teachers with training on making transitions smoother, just having an extra set of hands can make a huge difference.

      These are all things parents can look for at their child's centre. Are teachers getting breaks? Do administrators spend time in the classrooms? Do classrooms seem to run smoothly with a good routine? Child care centres with a supportive culture will be where teachers like coming to work because they feel confident in their abilities. This, in turn, will allow them to help their children grow and learn safely.

      Tips That Will Help Your Child During Their Transition Into Daycare and Lower Their Stress Levels. 

      Implement a Very Slow Integration.

      Researchers split the "start" of daycare into "adaptation phase" and "separation phase". The adaptation phase is when an infant starts daycare with the presence of their parents. Bringing on a new environment and a new caregiver causes elevated levels of stress for the infant. They learned that 1) the stronger the bond between mother and child (i.e. the more secure they are with their mother) before the start of daycare, the lower the levels of cortisol when they begin daycare, and 2) the longer the mother stayed in the adaptation phase for integration into daycare, the better the attachment become with their mother.  

      Choose a High-Quality Daycare. 

      Low child/caregiver ratio. According to research, the best child to caregiver ratio is 4:1 (For every adult, there are 4 children). Also, the number of children in a group should be no more than 8. The more children there are, the higher the noise level, and this can be overstimulating for children. Also, a higher chord to caregiver ratio means that the child will have a greater difficulty building an attachment to them. If possible, try to select a daycare that minimizes the number of children in a group.

      Low staff turnover. Your child should develop a strong bond (secure attachment) with their caregiver. When a child is younger than 3, it is important for them not to have multiple caregivers as this means they might have difficulty creating an attachment with them. If your daycare has a high staff turnover or various caregivers for your child, this may increase their stress. High-quality home daycares can be great since your child will be one caregiver for many years.

      A sensitive and caring caregiver. Research has shown that if a child establishes a secure attachment to their caregiver (other than their parent), then this caregiver can help the child effectively diminish stress levels in a time of stress. However, for this to happen, caregivers must provide sensitive, responsive caregiving.

      Increase Bonding Time With Your Child.    

      If your child begins to exhibit different behaviour at home (more crying when they are with you, wanting to be in your arms more often, changed eating habits, changed sleeping habits, etc.) or at daycare, they might be feeling more stressed. 

      Spend more time with them when you are at home. Increase cuddling time with them. Try doing some baby massages if they are young and increasing skin-to-skin time through this activity (which helps build a stronger attachment). 

      Contrary to popular belief, holding your baby and spending time with your child is not "babying" your child. The stronger your child's attachment with you, the more comfortable they will feel when you are not around. (Stay tuned for an article on attachment, make sure you subscribe to our newsletter not to miss it!).  

      Solutions to Toddler Stress

      Keep Calm and Carry On

      "It's important to stay calm and acknowledge your child's feelings. But don't go overboard. You want to convey that you understand your child's feelings but that nothing bad will happen when you are apart. So your child can learn that he doesn't have to be immobilized by stress or fear." Dr Hackney suggests a tactic she describes as "matter-of-fact empathy," where the message is conveyed through words, body language, and tone of voice that you understand how your child feels but you're not changing course. For example, if a child doesn't want to go to daycare, say, 'I know, this is hard. I know you don't want to go. You're having fun at home,' but continue your usual routine and then head out the door as planned. This way, "all of your language is saying, 'I completely understand, but we're still going.

      Stick to the Schedule

      Maintain daily routines such as going to daycare or preschool, feeding, and preparing for bedtime. Routines allow toddlers to control what to expect and go a long way in creating a sense of calm. Keeping a consistent bedtime is particularly important because children can become stressed more easily if they are overtired. 

      "To help your child cope with the stressors of life, make certain that she is getting a good night's sleep, adequate naptime, healthy meals, and plenty of daily activity. It's best to postpone other changes -- such as potty training or transitioning to a big-kid bed -- that can disrupt the normal schedule. Instead, wait until life has settled into a comfortable pattern.

      Allot Time for Breaks

      Build-in adequate time for rest breaks, naps, and preparation for activities. Children live according to a much slower clock than adults do. "They don't give a thought to what they might be doing next. Instead, they pause as they watch the cat sleep, examine the carpet's colour patterns, and ponder the reasons for having toes. So examine your schedule to make sure you're focusing on priorities and taking time to enjoy your child's company. Make sure that you're not taking away any special moments by rushing to the next item on the schedule.

      Plan and Allow for Processing

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      How parents present a stressor, frame and discuss it, and answer questions gives children boundaries on how to perceive it. The idea is to start honest and small. For example, if you need to tell your child about someone passing away, try saying, 'We wanted to let you know that Grandma was very sick and she died." 

      If he has questions, you can then decide how to describe it (giving a toned-down version or rephrasing it based on your beliefs and comfort level.) Read storybooks about the new baby's arrival a few weeks in advance if you're trying to explain a new sibling. Make the initial introduction very focused on the toddler as a new big brother or sister, and keep his normal routine to make the transition smoother. Convey the message that his thoughts and feelings matter, but don't give too much information that can't be processed.

      Monitor TV Exposure

      Be mindful about what programs your child is absorbing. When a parent is watching the news, and a child is in the room, there's exposure to all kinds of violence. Reserve certain TV shows after the kids are in bed or limit how long you watch the evening news. Exposure can often be unintentional, so try scheduling different TV times for different-aged kids or make sure all the programming is geared toward a younger child if she's in a room with others. Visit websites like kids-in-mind.com or commonsensemedia.org to see the reviews and ratings of various programs so you can make informed decisions about TV viewing.

      Give Extra Hugs and Kisses

      When adjusting to change, extra one-on-one attention and a few more daily cuddles and kisses can provide just what a toddler needs to feel comfortable and settle into new patterns. Whether the stressor is negative or positive, the added affection can help boost the child's confidence and self-regulation skills, enabling her to be more flexible and resilient to change.

      Stress is a part of life and can be found all around us. Child care is no exception. There is good stress and bad stress. Stress can motivate us to get things, but too much stress can make our lives seem too hectic and overwhelming. Remember that children feel stress just as adults do. Child Care providers should be aware of the stressors each child is experiencing and should be active in helping children in their child care programs manage and cope with stress. 

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