Birth to three matters - Communities and Local Government

It is only by being given oppo rtunities tom a ke choices like those suggested abovet h at children begin to understand theco n s e q u e n ces of their decisions and tobe come co m pe te nt at ste e ring their ow nl i fe co u r s e s. It may be that one of the keyf a ctors leading to the later life succe s s e s(including gre ater freedom from ment a lillness) of the Hi g h / S co pe pre s c h oo lp rog ramme (Schwe i n h a rt et al 1993) is theemphasis on the ‘Pl a n ,d o, rev i ew’ ro u t i n ewhich places the re s po n s i b i l i ty for howt h ey spend their time on the childre n .The ‘Birth to Three Matters’ Frameworkincludes the following developmentalpointers relating to Healthy Choices, forpractitioners:-From birth, young babies showpreferences for people and for whatthey see, hear and taste.Babies discover more about what theylike and dislike.As young children become moremobile and their boundaries widen,they make choices that can involvereal risk.Children become more aware thatchoices have consequences.Cl e a rly, w h e re babies and ve ry yo u n gc h i l d ren are co n ce rned it is pri m a ri ly theirmothers who take re s po n s i b i l i ty fo rp ro te cting and promoting their child’sh e a l t h . A range of factors co nt ri b u te tohealth and we l l - be i n g. For ex a m p l e, s oc i o -e conomic inequalities (which are moref u l ly discussed in the section of this texton pove rty) have been shown to lead tod i f fe re n ces in childre n’s health. Mo re n o( 1993 :23) re po rts that low birt h - we i g ht isalmost always ‘the result of pre n atal soc i o -e co n o m i c, l i fe s tyle or be h av i o u ral facto r son the part of the mother and family’.Bra d s h aw (2001) rev i ewed social andb i o l og i cal factors in the deaths of childre nunder three in England and Wales fro m1981 to 1997 and found thema p p rox i m ate ly halved over this pe ri od.Howeve r, Bra d s h aw’s (2001) textco n ce rning re s e a rch on pove rty andc h i l d h ood re po rts that although deat hrates we re decreasing be tween 1987 and1991 , gender diffe re n ces re m a i ns i g n i f i ca nt, with the death rate for boysaged be tween one and 14 years 30 pe rce nt higher than for girl s.Wachs (2000) rev i ews the ev i d e n ce ofre s e a rch into the links be tween nutri t i o n a ldeficits and be h av i o u ral deve l o p m e nt.He re po rts that seve re po s t n at a lm a l n u t ri t i o n , both mild and seve revitamin and mineral deficiencies, a n dc h ronic under- n u t rition have been show nto lead, for ex a m p l e, to problems such asg e n e ral and specific cog n i t i ve deficits;l ower neonatal re a ct i v i ty; a p at hy,i rri t a b i l i ty, l ower act i v i ty levels and higheri n h i b i t i o n ; and increased risk of poo re rcog n i t i ve and academic pe rfo rm a n cere s pe ct i ve ly. Zeanah (1993: 353) discussesthe inte rp l ay be tween env i ro n m e nt andgenetics in infantile onset obe s i ty andi n fo rms us that ‘e nv i ro n m e ntal risk facto r ssuch as low soc i o - e conomic status arekn own to be strong pre d i ctors ofs u b s e q u e nt obe s i ty’.107