Indian Academy of Pediatrics Position Paper on Nurturing Care for Early Childhood Development.

Early childhood development (ECD) refers to the physical, motor, socio-emotional, cognitive, and linguistic development of a young child. The 'Countdown to 2030' global distribution of 'children at risk of poor development' indicates the need for urgent action and investment in ECD. Nurturing care enhances ECD, even in the presence of adversities. Strategic actions should exist at multiple levels: the family, community, health care providers and government. Previously, child health related policies and programs of the Government of India functioned in isolation, but have recently started demonstrating multi-sectoral collaboration. Nonetheless, the status of ECD in India is far from optimal. There is strong evidence that parenting programs improve outcomes related to ECD. This is dependent on key programmatic areas (timing, duration, frequency, intensity, modality, content, etc.), in addition to political will, funding, partnership, and plans for scaling up. Each country must implement its unique ECD program that is need-based and customized to their stakeholder community. Barriers like inadequate sensitization of the community and low competency of health care providers need to be overcome. IAP firmly believes that responsive parenting interventions revolving around nurturing care should be incorporated in office practice. This paper outlines IAP's position on ECD, and its recommendations for pediatricians and policy makers. It also presents the roadmap in partnership with other stakeholders in maternal, neonatal, and child health; Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum (NNF), World Health Organization (WHO), and United Nation Children Fund (UNICEF).

Temperature monitoring in newborns using thermospot.

OBJECTIVE: Hypothermia is a common problem in newborns. This is more so in community environment especially in low-birth weight and preterm babies. METHODS: A simple liquid crystal temperature monitoring device was used in 20 infants on a continuous basis to monitor for hypothermia. This was compared with the measurement of rectal temperature using a rectal thermometer. The colour changes and measures to be taken when hypothermia occurs was explained to the mothers and was well understood by all. RESULTS: The Thermo Spot was in agreement with the rectal temperature in 310 out of 313 measurements. This includes 299 times when temperature was normal; and 11 times when the temperature was hypothermic. It underestimated the temperature of three infants, falsely indicating hypothermia in a normothermic child with normal body temperature. It correctly identified hypothermia in every case. CONCLUSION: ThermoSpot device is a simple accurate device allowing continuous thermal monitoring of low birth weight infants, especially in resource poor setting.