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Initial phase of childcare needs research

The Yomiuri Shimbun

By Nao Yako/Yomiuri Shimbun Staff WriterThe Cabinet Office, the Health, Labor and Welfare Ministry, and the Education, Culture, Sports, Science and Technology Ministry urged local governments in December to carefully observe children who have recently been enrolled in childcare facilities, a request prompted by a rash of fatal accidents involving such children while they slept.

However, the government has yet to investigate the issue in detail. The truth of the situation must be swiftly ascertained, and the children’s guardians must also be informed.

Children under stress

Since 2016, these three government bodies have asked local governments to investigate serious childcare accidents resulting in death or loss of consciousness.

Five investigative reports have been compiled so far, with four of the cases involving deaths that occurred mostly during naps.

Two of the children died on their first day of enrollment, another on the ninth day, and another on the 19th day.

An expert council established by the three bodies to consider measures to prevent serious accidents at educational and childcare facilities has said, “Although the evidence is not clear, this seems to be a period when children are under a lot of stress, and childcare workers don’t thoroughly understand the circumstances of their development.”

The council urged the governments to inform that “close, attentive observation is especially important for children who have just been entrusted to a childcare facility.”

The three government bodies issued a notice on the matter to local governments and facilities on Dec. 18.

It is commendable that the national government issued this notice in response to local government reports.

However, its call to “observe children attentively” is vaguely worded and difficult to implement in actual childcare environments.

Although the health ministry has received reports of serious childcare accidents from local governments, it has yet to investigate incidents involving recently enrolled children.

A health ministry official said: “We haven’t seen it as a problem. We haven’t decided whether we will investigate.” A factual investigation conducted by the national government is crucial to planning appropriate preventive measures.

Gradual entry

Toshimasa Obonai, head of the pediatric department at the Tama-Hokubu Medical Center in Tokyo, and his colleagues investigated sudden deaths that occurred during sleep at childcare facilities from 2008 to 2012, and published their results last summer.

According to the results, 22 of 43 children died within 30 days of being enrolled at a facility. Six died on the first day, three on the second day, and another four within the first week.

Around 50 percent were less than 1 year old, and 40 percent were 1-2 years old.

Obonai said: “A drastic change in environment is thought to increase the risk of sudden death. Children’s inability to adapt to a new environment soon after being enrolled in childcare is probably one factor that leads to such deaths.”

Childcare workers say that caring for children in the first one to two months of their enrollment is difficult.

Many children aged 0-2 in particular constantly cry or refuse to eat.

To reduce children’s stress, some facilities practice “gradual entry.” The children initially spend a short amount of time at the facility, with the length of their stay gradually increased. This is often done over a one- to three-week period.

According to Konan University Prof. Masako Maeda, the chairwoman of the expert council, many facilities practiced gradual entry 20-30 years ago.

However, Maeda says a rising number of facilities ended the practice because parents said it was burdensome to pick up their children early.

There are different practices among local governments. Childcare facilities in Fujisawa, Kanagawa Prefecture, in principle gradually enter all children with prior consent from their guardians.

But in Shinagawa Ward, Tokyo, long childcare hours from the start are standard.

Maeda said: “It is thought that gradual entry can reduce the initial stress of daycare. However, we also have to be considerate of parents who can’t get time off work. We need to spread awareness of the importance of an initial enrollment period among parents and businesses.”

Demand for childcare continues to rise. Further research and discussion is needed on the initial phases of childcare enrollment to ensure the safety of children.

(From The Yomiuri Shimbun, Dec. 27, 2017)Speech

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