Finding childcare can be an anxiety-inducing experience for many working mothers, with the psychological well-being of children hanging in the balance, writes Gihan Shahine It was a warm morning, and the sun was reflected nicely on the colourful façade of the day-care centre where I had decided to leave my son Youssef. The nursery, not such a wow, exuded warmth and had a home-like feel -- not too many children and friendly staff -- and the children were laughing and talking in a way that signalled that fun was in the making. Youssef was 22 months old at the time, and he explored the place bravely, peeping into classrooms and looking around with great curiosity. Then he pointed excitedly at the toys in the outdoor garden and suddenly engaged himself in the unneeded task of re-ordering the chairs in the classrooms. Obviously he did not like the way they had been placed! However, this unexpected show of bravery melted the minute Youssef sensed I was about to leave. He held my hand tightly and decided not to move away. As a result, I had to spend time with him in the nursery on his first days there, and I used to feed him, watch the puppet show with him, and even play aerobics with him. Even so, my departure was always difficult for both of us. Youssef used to cry, begging me to stay with tearful eyes, and I felt very bad, not to say guilty, that I had to leave him. I would hide in the nursery to make sure he had stopped crying before I did eventually leave, a process, which, I came to realise, did not actually take more than a few minutes. Youssef still did not feel at home at the day-care centre, though. He did not mingle with the other kids, did not want to sit in class, and did not want to eat. He spent the first day in the garden driving a little car, hanging onto his little bottle of water and watching the other kids from a distance. He seems to have felt like a stranger. "Your son is untouchable," the nursery supervisor later told me with a laugh. "He did not want anyone to take him out of the car, and we had to move him to his class while he was still inside it." All this was a month ago, and today Youssef's behaviour has totally changed. Now he gives me a happy goodbye kiss when I drive him to the day-care centre, and he mingles happily with the other children and sits with them in class -- or rather walks about in class because he still does not like rules and discipline. He sends kisses to his teachers and his playmates, especially the girls, when he is about to leave. Youssef may not be alone in his experience, since for young children leaving home for a day-care centre is an often upsetting experience because it marks their first separation from their mothers. According to child psychologist Amira Shawqi, this experience may differ from one child to the next, since different children "may stop crying when they go to a day-care centre in a matter of days, weeks or even months." It is the quality of the care on offer, as well as the age and preparation of the child, that can make a huge difference to whether children remain unhappy or gain new social and linguistic skills away from home. There is almost a consensus among specialists that children should not start day care before two years old. "The child should remain attached to his mother for the first 24 months in order to achieve emotional stability and develop a well- balanced character in the future," says consultant paediatrician Amr Qatamish. However, it is rarely the case that one rule applies to all children, and that is also the case here: if the mother has to work, for example, Shawqi says that she "should spend extra-special time with her child in the evenings, in order to make up for her absence during the day." In all cases the mother should prepare her child for the inevitable separation and try to make this a gradual one. If a child suddenly finds himself in a new and strange environment, thoughts like "mother might not come back to pick me up", or "mother might not recognise me" can enter his mind, and a mother should aim to dispel such fears. "It is better if the mother spends time with her child in the day-care centre until the child feels safe," Shawqi goes on. "She should also make her separation a gradual one, leaving him for an hour or two in the first week, and then increase the hours gradually." The most important part is that mothers should not feel guilty when they send their loved ones to a nursery, she explains. Few mothers are qualified to provide their children with the environment needed to promote skills, mental development and psychological stability, and mothers may discipline their children in a way that backfires later. "Few can find the time to educate their children in the way that can be done in a specialised centre," Shawqi adds, "and the environment of the centre may be in some ways better for the developing child." Other child-development specialists and mothers also suggest that quality day-care can provide young children with an attractive, stimulating environment that helps develop their cognitive, linguistic and social skills. "Two-year-olds become less dependent on their mothers and more disciplined and sociable when they go to day-care," Qatamish says. Specialists also cite the example of two children who have been separated and given building blocks to play with. One of the children is left alone to play, while the other is assisted by an adult. The child under guidance will build taller towers sooner than the unassisted child. Even the most introverted child, as he or she plays with children of the same age, will tend to become more extroverted in a nursery environment. "I've seen it myself," Shawqi says. "There is a huge skills gap between children who join a nursery at an early stage and those who join it in the pre-school period. Those children who have attended the nursery typically know how to share with others, and they learn the ethics of apology, of dealing with adults and of ownership. They also gain self- confidence and self-esteem and develop leadership skills." Hanan, the mother of a two-year-old son, attests to the change in her son's character that came about after he joined a day-care centre. "He has become less dependent on me, and he can eat and get dressed alone," she says. "He now builds higher towers with blocks and solves difficult puzzles. He has also learned how to sit still in class and how to share things with others." All this is not to say that life at a nursery is always rosy. Not all teachers are equally suited to overseeing very small children, and some administrators regard their nurseries as more of a business than a vocation. Quality day-care can also prove costly, and parents may not be able to spend a significant part of their salaries on outside care. Suzanna Sami, the mother of three children, has looked at some 18 day-care centres in her area, and she has a mix of good and bad news to pass on about them. Her oldest son, Abdel-Rahman, for example, was left to cry until he fell asleep behind a tree in one of the best day-care centres in Nasr City, and the staff had to look for him when she went to collect him. "They did not know where he was, and when they found him his eyes were red and swollen," Sami says. As a result, she decided to change nurseries, and her second choice was much better. "Abdel-Rahman benefited a lot from going to the new nursery," she says, though she has little good to say about the nursery attended later by her younger son Mohamed. According to Sami, one of the teachers at this centre, which had a high reputation, hit Mohamed on the head. "A nursery may look great from the outside, but mothers should make sure it is not just a business and that children receive good care," Sami advises. Mothers should make sure that their children feel welcome at the centre and that the staff are caring and well-qualified. "Teachers should be well-trained to deal with young children, because the teacher-child relationship is crucial," she adds. The facility itself should be well-ventilated, clean and attractive. A good nursery should have a well-balanced programme that is both educative and entertaining. There should also be good communication between parents, administrators and teachers, all of whom should agree on matters of discipline. "If a child goes on crying longer than normal, showing that a child is not happy at a day-care centre, then the mother should immediately consider changing the centre," Shawqi adds. Much is at stake in cases of poor childcare, since it has been shown that the first five years are the most important in a child's life. Poor nurseries, serving as little more than "parking places" for children, can actually hinder the mental development of children. According to research carried out in Australia that measured the levels of cortisol, a hormone tied to stress, in 117 pre-school children in 16 day-care centres, children who regularly received quality care experience low stress levels. The study, spearheaded by Perth's Edith Cowan University, also showed that disadvantaged children from unstable homes may benefit from even a low-quality care environment, which may be better for their well-being. High stress levels can have a long-term impact on children's health and learning, researchers say, and chronically high levels of cortisol have been associated with learning and behavioural problems, as well as immune suppression and even brain damage. An equally worrying US government survey of 1,100 children found that some 26 per cent of children who spend more than 45 hours per week in day-care go on to have serious behavioural problems at kindergarten age. In contrast, the study found that only 10 per cent of children who spend less than 10 hours per week in day-care have equivalent problems. "The total number of hours a child spends without a parent, from birth through preschool, matters: The more time spent in child care of any kind or quality, the more aggressive the child," the study, published in the US journal Child Development, concluded. While Qatamish does not dismiss the results of such surveys in defending day-care centres, he says that parents should not worry overmuch about such findings. "There is no one rule which applies to all," he says. "Each child is a different case." Even the fact that children can face recurrent illness when they start mingling with other children at nurseries is not necessarily a source of worry. "Children will have to face such interaction eventually once they leave home for school," he says, and it is better for them to start interacting with others earlier rather than later because "they will gain immunity, which reduces the possibility of illness during kindergarten and elementary school, when repeated absence can lead to a real loss for the child."
