Early childhood development has a long-term influence on an individual′s physical development,brain development,mental health,and even has an impact on the health and wellbeing whose benefits last a lifetime and carry into the next generation.But a significant number of children are still at risk of stunting,whose development is the key to the well being of all mankind.The implementation of nurturing care can effectively improve the early development potential of babies,ensure children′s good health and nutrition,and protect them from threats.Nurturing care also means giving young children opportunities for early learning,through interactions that are responsive and emotionally supportive.This review systematically introduces the nurturing care framework and strategy,thereby providing a basis for further clinical and scientific research.

The early childhood development nurturing care consists of five major contents:child health, adequate nutrition, safety and security, responsive care and early learning opportunities. Among them, responsive care is an important way to promote early childhood development. This article summarizes and reviews the connotation, challenges, implementation and evaluation of responsive care, and explores the influence of responsive care on early childhood development.

Early childhood is a process of rapid changes in sleep/wake patterns development.Inappropriate sleep nurturing care will lead to a high incidence of sleep problems in infants and young children.And sleep problems will have adverse effects on children's physical growth, cognitive development, emotional behavior and others.In order to improve the sleep quality and prevent sleep problems of infants and young children, it is suggested that health care workers should provide sleep health knowledge and predictive guidance for parents, guide the caregivers to adopt appropriate sleep nurturing care behaviors, and promote early childhood development.

Except for the amount and type of food,researchers are increasingly aware of this,unresponsive feeding is a major barrier to health and nutrition.For this,responsive feeding is promoted in the feeding guidelines of WHO and UNICEF.This paper focuses on the scope,challenges,implementation plan,promotion strategy and effect monitoring of responsive feeding to promote the development of responsive feeding in infant care.

Objective To longitudinally examine characteristics and associated factors of parental sleep arrangements for infants aged 0-3 months,in order to provide reference for the predictive guidance of infants' early parental sleep arrangements. Methods This was a longitudinal study of 156 infants with repeated measures from birth to 3 months in 5 cities of China from 2013 to 2015. The parental sleep arrangements were measured at 14 days,1 month,2 months and 3 months after birth. The statistical description and CMH chi-square test were conducted. The generalized linear mixed models were fitted to analyze the associated factors. Results The proportions of infants who fell asleep at night by parents holding,patting or accompanying beside the bed,and alone were 54. 4%,35. 9% and 9. 7%,respectively,and the proportion of falling asleep by holding increased over time (P＜0. 000 1). The proportions of asleep,drowsy but awake and fully awake when the infants were placed on the bed at bedtime were 63. 7%,28. 6% and 7. 7%,respectively,and the proportion of drowsy but awake decreased over time (P=0. 000 3). The proportions of co-sleeping,room-sharing without bed-sharing,slept on parents' arms or backs and in a separate room were 53. 8%,42. 4%,2. 0% and 1. 8%,respectively,and the proportion of co-sleeping increased over time (P＜0. 000 1). Parents' education level of university and above,household income of 5 100~8 000 yuan and father depression were statistically significant on sleep arrangements(OR=0. 46,2. 55,1. 60,0. 57,P<0. 05或<0. 001). Conclusions Parental sleep arrangements for infants in early stage mainly include falling asleep with soothing,putting infants to sleep asleep and co-sleeping,which need to strengthen predictive guidance.

Objective To investigate the needs and influencing factors of family nurturing for infants, so as to provide reference for promoting the combination of medical education and care services. Methods From September to November 2020, 3 439 infants were selected from 9 provinces and 12 cities in China for questionnaire survey. Parents were asked to fill in general information and family rearing questionnaire to collect the needs of infant families for nurturing guidance. Results Among 3 439 infants, 29.7% had the need for nurturing guidance, especially for responsive care and early learning opportunities. Logistics regression analysis showed that the main caregivers were father(OR=0.476,95%CI:0.361 - 0.629)and(maternal) grandparents(OR=0.455,95%CI:0.304 - 0.681), farmers(OR=0.395,95%CI:0.240 - 0.649)and retirement(OR=0.612,95%CI:0.500 - 0.750)were protective factors for guidance needs for infants and toddlers family nurturing care. Stem family(OR=1.295,95%CI:1.101 - 1.523), single-parent family(OR=2.631,95%CI:1.405 - 4.927), caregivers with educational level of college/graduate(OR=2.180,95%CI:1.600 - 2.971), postgraduate and above(OR=3.116,95%CI:2.109 - 4.811)and average monthly household income of >10 001 - 20 000 yuan(OR=1.815,95%CI:1.407 - 2.340), above 20 000 yuan(OR=2.846,95%CI:2.125 - 3.813)were risk factors for demand for high guidance needs for infants and toddlers family nurturing care. Conclusions At present, families in China have a certain need for guidance on the nurturing care of infants and toddlers. Medical and health care institutions, especially maternal and child health care institutions, should continue to improve their professional guidance and health services for the nurturing care of infants and toddlers in order to further improve the quality of family care.

Objective To explore the effects of early parenting ideas and behavior intervention on feeding and neurobehavioral development during infant period, so as to provide basis for medical institutions to popularize parenting care knowledge to parents. Methods From January to August 2019, a total of 120 healthy children at the age of 1 month old, who took physical examination in Department of Child Health Care, Shaanxi Provincial People's Hospital, were selected in this study, with 60 infants in the intervention group and 60 infants in the control group.The control group received regular physical examination and health guidance, while the intervention group received early parenting philosophy and behaviors intervention additionally.At the age of 12 months, the family environment, infant feeding index, complementary feeding behavior, physical and mental development indicators were compared between the two groups. Results Compared with the control group, children in the intervention group had better family nurturing environment(χ²=34.48,P<0.001), higher feeding index scores(t=5.23, P<0.001) and feeding behavior level(χ²=18.23,P<0.001).The measured values of weight (male:Z=-2.12; female:Z=-2.11), body length (male:Z=-2.50; female:Z=-2.13) and head circumference (male:t=2.19; female:Z=-2.16) in the intervention group were all significantly higher than those in the control group (P<0.05).In the intervention group, the gross motor function (Z=-2.49), fine motor function (t=3.02), adaptive ability (Z=-4.75), language (Z=-2.81), social ability (Z=-3.06) and total developmental quotient (DQ) (Z=-4.28) were significantly higher than those in the control group (P<0.05). Conclusion Early parenting ideas and behaviors intervention can create a good family nurturing environment and feeding conditions for infants, which is beneficial to the physical growth of infants and to promote their intellectual development.

Promoting nurturing care is a coring intervention of early child development,and early learning opportunity is an important strategic action of nurturing care. However, child health care providers are not very familiar with the concept and content of early learning. So it is necessary to understand this term, which influences what kind of curricula are provided for parenting and health services.

Objective To explore the association between home environment and infant language delay,in order to provide reference for promoting the language development in early childhood.Methods A total of 112 infants diagnosed with language delay were enrolled as case group in Shanghai Children′s Hospital from November 2017 to August 2018,and 127 normal infants matched with gender and age who took physical examination in the same hospital at the same period were as control group.Chinese Home Nurture Environment Questionnaire and Infant Language Delay Questionnaire were used to conduct this survey. Results The education level of parents in children with language delay was significantly lower than that of normal children.Likewise,the developmental quotients (DQs) of motor,object,language and social abilities in children with language delay were lower (P＜0.01).Besides,the normal children had better home environment than language delay children(Z=-2.884,P=0.004),and the differences were statistically significant,especially on emotional warmth & home environment atmosphere,social adaptation & relfcane,language & cognitive information environment (Z=-2.032,-3.974,-4.835,P＜0.05 or 0<0.01).After controlling confounding factors,home nurture environment was found to be a significantly influential factor for language development of children (P＜0.01).The language developmental quotient was relevant to home environment(r=0.480,P＜0.01),and if children′s home environment scores increased 1 point,the language developmental quotient (DQ) increased by 0.45 on average. Conclusion Home nurture environment is one of important influential factors to children′s language development,so it is suggested to give more opportunities for children participating in cognitive activities,thereby improving the quality of parent-child interaction.

Objective To evaluate the effect of the combination of nurturing care by medical, nursing, education and family parenting in promoting the development of preterm infants, so as to provide basis for the follow-up monitoring of high-risk preterm infants. Methods A retrospective analysis was conducted in 71 cases of high-risk premature infants followed up in Hubei Maternal and Child Health Hospital from January 2017 to June 2018.Infants followed up in early development clinic were selected into the study group, those followed up in general outpatient clinic were enrolled in the control group. Infants in the study group adopted medical-nursing-education-family parenting intervention, while children in the control group were given conventional guidance. Physical development and neuropsychological development levels of high-risk premature infants within 12 months of corrected age were dynamically monitored and compared between the two groups. Results The difference between the study group and the control group at 1 month of corrected age was only significant in body weight (t=4.709, P<0.05). At the corrected age of 3, 6 and 12 months, the body length, body weight, head circumference, mental development index (MDI) and psychological development index (PDI) of infants in the study group were significantly higher than those in the control group(P＜0.05). Time effects, within-group effects and interactions for length, weight, head circumference, MDI and PDI scores were statistically significant between the two groups (P< 0.05).Compared with the control group, the pass rate of 20 neuromotor development items at the corrected age of 3 and 6 months in the study group were significantly higher (χ²=4.064, 8.414, P<0.05), and increased more significantly with the increasing of age. Moreover, the prevalence rates of intellectual deficits and motor development delay at the corrected age of 12 months of infants in the study group were significantly lower than those in control group(χ²=4.769, 5.182, P＜0.05). Conclusion Medical-nursing-education-family parenting care can not only promote the early development of high-risk premature infants, but also reduce the occurrence of intelligent defects and motor development delay, which is helpful to repair brain injury and to improve the development level of high-risk premature infants to a certain extent.

It has been widely recognized that the early stage of life is a critical period for brain development, which is of high plasticity. Evidence from brain science has demonstrated that nurturing care environment has an important influence on the structure and function of children's brains, as well as their psychological and behavioral development. During this critical stage, good health, adequate nutrition, responsive care, security and safety, and opportunities for early learning all together provide an early environment that children's brain development requires, and further promote the development of children's cognitive functions, including sensory, perceptual, sensorimotor, language, cognitive, emotional and social abilities, to fully make the rise of early developmental potential. Taken together, in an effort to promote children's health, it is of pivotal importance to widely carry out nurturing care under the guidance of brain science and also create an optimal caring environment to support early development and especially the development of the brain.

Objective To understand the status of eating behavior problems of 3 to 6-year-old children in Urumqi,and to explore the relationship between family nurture environment and eating behavior problems,so as to provide reference for the prevention of eating behavior problems of children aged 3-6 years. Methods A stratified random cluster sampling method was used to collect 1 070 children aged 3-6 years from 7 kindergartens in Urumqi from November.2017 to January.2018. Management of Feeding Difficulties(IMFeD) and 3 to 6-year-old Children's Family Nurture Environment Scale were used to assess family nurture environment and eating behavior problems. Results The detection rate of children's eating behavior problem in 3 to 6-year-old children in Urumqi was 55.89%. There were significant differences on the scores of language/cognitive information,emotional warmth/self-expression,social adaptation/self-care,neglect/intervention punishment,activity diversity/game participation and total score of family nurture environment between children with eating behavior problems and children without eating behavior problem(Z=-8.506,-7.395,-9.393,-9.348,-9.773,-12.618,-13.633,P<0.000 1). Multi-factor analysis showed that social adaptation/self-care,neglect/intervention punishment,activity diversity/game participation and environment atmosphere were influencing factors of eating behavior problem of children aged 3-6 years(P<0.01). Conclusions The detection rate of children's eating behavior problems in 3 to 6-year-old children in Urumqi is higher. Family nurture environment is closely related to children's eating behavior problems,and should be actively improved to prevent eating behavior problem.

Objective To understand the current behavior problems of preschool children in Jiangsu province and their relationship with home nurture environment,and to provide theoretical basis for early intervention of children's behavior problems. Methods Cluster random sampling method was used to select children aged 4~6 years from Nanjing,Nantong,Zhenjiang,Suqian and Yancheng cities,children behavior checklist and 3~6 years old Children Home Nurture Environment Scale were applied. Results The total detection rate of behavioral problems in preschool school was 7.81%,and there were significant differences on the detection rates of two behavioral factors ("somatic complaint" and "attack") between boys and girls.The detection rate of adverse home nurture environment was 13.11%,there was significant difference in the detection rates of families environmental factor,"environment atmosphere" between boys and girls.The difference in the behavioral problems detection rate of preschool children in different family nurture environment was statistically significant.Factors influencing the behavioral problems of preschool children were mainly "neglect of interference" and "environmental atmosphere". Conclusion Home nurture environment has significant influence on preschool children's behaviors.So it is important to build pleasant home nurture environment in order to promote healthy development of early behavior.