Role of Pediatricians in Early Childhood Nurturing Care Related to Safety and Security

The five components of nurturing care for early childhood development (good health, adequate nutrition, responsive parenting, early opportunities for learning, and safety and security) are essential for the attainment of the optimal developmental potential of a child, and enabling him/her to become a productive adult. Safety is a state of protection from hazards caused by natural forces or unintentional human error, whereas security comprises of protection from hazards resulting from deliberate, harmful actions or inimical behavior. Unlike the other components, safety and security have been least addressed by health programs in India. The forms of lapses in safety and security in young children include injuries, neglect and maltreatment (physical, emotional, sexual abuse), the magnitude of which is difficult to ascertain in the community. Many mishaps can be avoided by simply understanding child development, taking precautions, and environmental modification. Issues related to safety and security are usually not addressed in routine office practice. Pediatricians have multiple roles and responsibilities. They need to utilize every opportunity to discuss preventive and promotive health care with parents. Converting immunization days to holistic well child visits is an ideal strategy, in which parents can be educated about preventing avoidable injuries and informed about how to keep their children safe and secure. Pediatricians should recognize indicators of volitional injury, neglect and abuse, and be competent in their management. They need to be aware of child rights and the legal protective measures as well as their own their legal obligations. They should network with various agencies involved in child welfare and protection.