Universal Early Childhood Daycare Has Been Proven to Damage the Children Who Have Been Through It

And may be at the root of the ongoing and growing child mental health crisis

By every objective measure, child mental health has gotten dramatically worse in the last few decades. Depression and anxiety, formerly rare in young children, have skyrocketed. In 1986, fewer than 2% of adolescents used a mental health service. Now, nearly a quarter of high school students have a diagnosable mental disorder. Lest we be tempted to blame this rise on better diagnosis or less stigma today, meta analyses can tease out incidence of depressive symptoms (such as sleeplessness, fatigue, isolation) in different eras, allowing a better grasp on actual rates of depression, not over/under-diagnosis. Meta analyses confirm a severe and worsening pediatric mental health crisis.

This modern surge in child distress— with more serious mental illnesses diagnosed at greater frequency and at younger ages— suggests a new kind of childhood trauma, harmful input, or epigenetically-damaging lack — something both widespread and profound, that is not being noticed. As morbid obesity and psychiatric meds now apply to grade schoolers, we must look further upstream for explanations.

Of course, there is one radically-novel, now-fairly-commonplace experience of early life, which came into existence right before our children’s mental health fell off a cliff. In the mid 1980’s, America embraced center-based group daycare for babies under age one.

Consider this timeline:

1971 After two years in operation, KinderCare (a well-known American chain of daycare centers) has 19 centers.

1985 After 16 years in operation, KinderCare opens its 1,000th center, and begins admitting infants under age 1.

1987 Growth of KinderCare hits its peak - now opening a new center every three days. 

1988 Incidence of Autism begins abrupt rise. Vaccines blamed.

1990s Incidence of ADD/ADHD begins abrupt rise. Human genes/biological variation/better diagnosis blamed. Academic performance, after increasing for decades, suddenly stagnates/ slips. Teachers/ low school standards blamed (leads to "No Child Left Behind").

1999 Columbine High shooting... Satanism, violent video games, and heavy metal music blamed. 

2000s Incidence of teen depression and suicide begins abrupt dramatic rise. Bullying, social media, and elite college admission pressures blamed.

2010s Universities report an explosion in mental health problems on campus, with exponentially greater numbers of kids struggling to cope - ‘snowflakes.’ Participation trophies, i-phones, and helicopter parents blamed. Opioids take hold. Pain prescriptions blamed. Dysphoria and self-rejection spike in young people. Innate 'Gender Identity’/ social media influences blamed.

While some of the concurrent forces receiving blame may be relevant and cumulative, we may be missing a key factor entirely.

What if an initial spike in institutionally-cared-for, very-young babies (from close to zero, prior to 1985, jumping to roughly one-third of babies) explains each of these subsequent spikes, as one neuro-developmental blow unspools in multiple ways over the lifespan? The timing is certainly eerie: autism spiking in three-year-olds, ADHD in grade schoolers, suicidal ideation in teens.  Rates of childhood obesity have tripled since the 1980’s, with morbid obesity striking at much earlier ages today too. In meta analysis, childhood obesity is associated with early full time care.

Lack of self-regulation is an underlying problem in a number of mental afflictions, as well as over- or under-eating.  Without an internal mechanism for intuitive emotional self-regulation, people frequently use food, drugs, gambling, or other dopamine-producing stimuli instead. Achieving emotional self-regulation is a key accomplishment of early life, gradually learned by age three or four, via repeated modeling and being co-regulated by a trusted, beloved caregiver.

Ever since the Mommy Wars ended in an exhausted, bitter truce, studies showing bad news about group daycare have tended to be presented cautiously, so as not to upset women, whether by calling into question a social change that’s widely regarded as a feminist triumph, enabling women’s economic and social liberation— or demonizing those moms for whom daycare is compulsory for economic survival.  But what if scaling up homecare (say UBI for young families) is cheaper and more effective for launching stable children in the long run? Tiptoeing around the damaging effects of early daycare may hold at bay the paradigm-shifting conversations we need.

The worst effects of daycare are seen in pre-verbal babies, infants under age one who attend full time center-based care, and whose home environments are not substandard. (For deprived children in substandard homes, attending an admittedly-hard-to-find "high-quality” daycare is better than no daycare at all.)  But for non-deprived children growing up in average homes, the small cognitive advantages of attending early daycare (relative to home-reared peers) fade over time, increasingly outweighed by deficits in “non-cognitive” skills, that not only persist but worsen.

“Cognitive” skills can be taught in a classroom: meanings of words, names of colors, rules of conduct, basic facts. “Non-cognitive” skills determine our capacity for acquiring cognitive skills: when we fail, do we get frustrated and give up, or do we try again? Positive personality traits turn out to be even more important to later life success than cognitive skills— qualities like confidence, persistence, focus, agreeableness, and emotional self-regulation.

A heavily subsidized universal daycare project that launched in Quebec in 1997, with impacts analyzed in 2015, provides stark evidence of the ’non cognitive’ harms of early center-based care.  

In order to encourage greater female workforce participation, Quebec began offering $5/day child care to all citizens.  The program quickly met its own goal: successfully inducing many more young mothers to join the workforce. It ramped up swiftly, beginning by offering placements to all four-year-olds in 1997-1998. Eligibility dropped younger each year, as new centers could be opened.  By 2000-2001, the program included newborns.  Both the large and diverse sample size of families partaking of this care and the rapid “negative shock” of the newly-launched program allowed ‘results’ to come into especially clear focus.

By comparing the Quebec children’s psychological and behavioral outcomes with age-matched peers in other provinces, and by comparing children in Quebec who began as newborns with their elder ‘siblings,' who started at older ages, discrete negative effects of early group care emerged, beginning with markedly higher aggression, anxiety and hyperactivity in daycare-exposed children by early elementary school (ages 5-9).  These problems persisted: by older teens, “program exposure is associated with worsened health and life satisfaction, and increased rates of criminal activity. Increases in aggression and hyperactivity are concentrated in boys, as is the rise in the crime rates." These findings were similar to an earlier investigation by the National Institute for Child Health and Human Development, which began in 1991 and followed 1364 children: extensive use of early daycare correlated with behavior problems and negative social outcomes at four and a half, and on through age 15 (when the study ended). Full time day care predicted more teacher conflict, worse parent-child relationships, and high risk behaviors, like using drugs and alcohol.

Why, then, do we continue full-bore towards a goal of universal early daycare in America, as though Quebec’s results never happened?  Children fare poorly within existing early-care systems— which may need to be entirely re-thought, not expanded.

In reality, group daycare from infancy is still an experiment-in-progress: the first daycare-raised babies are only in their thirties today, and just becoming parents themselves.  What, if any, are the second-generation impacts of being parented by someone who has “non cognitive” deficits— someone who did not receive adequate co-regulation themselves as a child? Is adult incapacity for modeling emotional self-regulation to children a part of our steepening pediatric mental illness graph?

Modern sociologists, psychologists, and journalists (many of whom used daycare with their own kids) have reported on the variety of discrete 'disadvantages and risks’ of group care, like increased aggressive behavior, but tend to be quick to reassure parents that such problems are outgrown over time, or that lingering issues for a few children are statistically counterbalanced by cognitive advantages for the group. This information dominates headlines and Google searches, and is still in wide circulation.

Even the Quebec study itself suggests, in its conclusion, that we need to figure out how daycares can "teach non-cognitive skills" (!), apparently not considering that, in order to be absorbed, "non-cognitive" skills may require elements not available in group care, like intimacy, modeling and constant co-regulation within a bonded relationship.

As one analyst commented, "Let’s suppose that universal daycare is in fact the problem. What’s the solution? How can non-cognitive outcomes be improved?  This is probably the most important question, and BGM [Baker, Gruber, and Milligan] offer no guide to answering it... they don’t have a structural model that maps inputs such as the curriculum, funding and how daycare providers are trained into non-cognitive outcome.”  

The study’s conclusion remains blind to the idea that acquiring “non cognitive” skills, such as self-regulation, is an implicit, non-verbal, sensory, and deeply relational process, that unfolds via the intensive modeling and one-on-one “serve/ response” interactions provided by the dyad.

From receiving attentive, responsive, love-object care, the baby absorbs preverbal self-states and emotional experiences which sculpt and influence the brain's developing habits, systems and set points. Being calmed by a well-regulated mother habituates the infant to the experience of calming down through slowed breathing and soothing talk. Over the first few years of life, as Dr Allan Schore puts it, “the right brain of the mother becomes the right brain of the child.” 

Perhaps the common language term “mother” is jarring to the contemporary ear when invoked in this scientific context. But when we abandon “mother” as a default term in the interests of inclusivity, (in favor of “attachment figure” or “primary caregiver,”) it may erode our sense of babyhood — a time when immutable, primate, mammalian needs must be satisfied. Mothers and mothering matter to babies: even babies adopted at birth can suffer a sense of deep shock from the loss of their biological mother, whose body they have lived inside for nine months, hearing the soundtrack of her heartbeat and voice, feeling the shake of her laughter and the familiar rhythm of her gait. This sensory bond is formed well before birth. Without either denigrating or excusing fathers, or the myriad alternative arrangements in which individuals have been able to thrive, there can be no perfect substitute for that unique bond. Our language should not seek to euphemize this reality away.

An erosion in basic cultural knowledge of early childhood, perhaps born of outsourcing baby care for a generation, is manifest in some of the new psychiatric diagnoses being applied to very small children. “Separation Anxiety Disorder” is now diagnosed in toddlers. For essentially all of human history, separation anxiety has been considered a normal stage of babyhood. A mother leaves her baby’s sight, even for a moment. He freaks out, thinking she has abandoned him. This only becomes a “disorder” when a mother can’t flow with it and reaffirm her presence, helping the child to gradually grow past the fear. We ask too much of young babies when we expect them to separate from mothers without sadness or protest and endure a nine hour wait for a reunion with equanimity. We pathologize a developmentally normal need. 

Gender Dysphoria/Transgenderism is the newest bucket into which we are putting troubled kids who lack a stable, coherent, realistic sense of self, whose ‘non cognitive skills’ are poor, and whose self-rejection is targeted to their sex. We now ‘affirm’ these kids as ‘trans’ before investigating any of the formerly-well-known, verifiable reasons for disturbances in sense of self— abuse, neglect, PTSD— thus maintaining denial of developmental harms happening to children on our watch.

Mothering, it turns out, is hard to scale up. In very early life, mothering is essentially 24/7 mind-body-state-tending. An aware mother notices a baby’s subtle cues of hunger, distress, or curious interest, and responds swiftly, whether to address a need, engage socially, or otherwise restore equilibrium. Especially under age one, when self-regulation skills are nil, a baby requires a great deal of "external co-regulation” just to manage the sensations of his body and the intensity of his feelings.

How can one daycare worker possibly co-regulate four or five infants, (the worker to child ratio in Quebec daycares for infants aged 0-17 months is now five to one) who may not even be emotionally bonded with her? How can her responses be as consistent, empathic, and swift, if her attention and arms must be shared among five equally-needy babies? What if one baby is smiling eagerly, one is whimpering and weeping, and one is throwing up? A single adult may keep five babies fed, napped, smiled at, and dry— but this is far from the same degree of emotional and physical shelter provided by responsive one-on-one care. 

Just imagine a mother who births quintuplets. This happened in my town. She was inundated with free diapers, free baby food, strollers, cribs, a minivan, and offers of recurrent daily help— because everybody knew there was nothing normal about one mom caring for five tiny babies. Yet this ratio is typical in early daycare.

Until age two or three, a baby’s right brain develops more rapidly and extensively than her left. The right brain is not the seat of logic or fact, but rather of emotion, intuition, unconscious processes, and “wallpaper" notions about reality and the self, such as “the is world safe,” “people care about me,” or “when I do things, I get responses” (aka an 'internal locus of control'). Maternal responsiveness is key to imparting such confident internal feelings. Swift attentive care not only regulates a baby moment by moment, it also gradually imbues her with intuitive self-calming strategies, and a overall sense of wellbeing. Paradoxically, it is only by someone interpreting and handling everything for a baby that she gradually comes to feel “I can handle it.” Dr Allan Schore posits that attaining the ability to self-regulate— ‘I can now do what she used to have to do for me’-- is prerequisite to being able to feel a sense of self.

Science has long known that even the best daycare is quite stressful. This can be measured by babies' higher and higher salivary cortisol throughout the day, unlike those cared for at home (whether by mothers or nannies) whose cortisol is highest upon waking and drops as the day goes on. This abnormal rising-cortisol pattern has been measured even into the teen years of kids who attended daycare as babies— an extremely long-lasting biophysical change. Taking an all-day, every-day cortisol bath cannot help but sculpt a more anxious, vigilant brain, as well as create very different internal coping systems and assumptions about reality. 

While babies who attend daycare mostly bond preferentially to their mothers, could this actually create other problems? Could it be developmentally overwhelming for a small, non-verbal baby to be separated from her primary attachment figure all day long? Might this explain the rising cortisol?

Or perhaps group care's deleterious effect on “non cognitive” abilities comes in part from not being held enough. In the late 1970’s, Dr James W Prescott of the National Institutes of Health conducted an extensive study of the childrearing practices of dozens of indigenous peoples, and cross-correlated them with later social wellbeing (low violence, low suicide). There was one childrearing practice that could predict social health over 90% of the time: in the healthy societies, small babies got carried around. It turns out that the somatic stimulation of being carried is important to robust neurological development. The vestibular system of the brain (which governs perception of motion) is heavily connected to later-forming areas like the limbic system (emotion) and the prefrontal cortex (self-control). In Dr Harry Harlow’s experiments, baby rhesus monkeys raised with a randomly-moving fake mother they could cling to were able to integrate normally with other monkeys later, whereas baby monkeys raised by still mother-surrogates never could. In daycare, babies get at best 20% of the carrying they would get in a dyad, which can be considered a form of sensory deprivation.

Developmentally-normal mixed-age groups, such as in a small hunter-gatherer tribe, provide constant modeling by elders, and have fewer babies per adult. Now we’ve got single-age environments with radically reduced adult presence and scanty modeling. Do some kids need more one-on-one modeling in order to absorb “non-cognitive” skills, and they fall through cracks of group care?  Is duking it out with a dozen other two-year-olds simply too challenging or stimulating, as opposed to being in mixed age groups, with an array older kids who know how to cosset babies?

While particularly gifted, empathic mothers, very warm families, or temperamentally-sturdy babies may weather early daycare without apparent problems, we have no way of knowing in advance who these babies and mothers are, or what mitigating practices (such as extended breastfeeding, co-sleeping, or possibly having siblings in the same daycare) may help co-create positive outcomes. We have no way of knowing which daycare providers will love our kids, and which will move away or quit. And even a baby who adjusts well to a loving caregiver will necessarily lose that relationship— whether due to staff turnover, or simply by graduating on to the next-age room. The loss of a beloved attachment figure is one of the worst traumas a child can experience. Daycare thus carries a constellation of possible developmental injuries: less carrying, less external co-regulation, less relational stability and depth, more fear, more stress, and more loss. Is this the mental wallpaper we want for our kids? During the very time a baby’s psychological scaffolding is being built, daycare assails it.

When we consider the hundreds of billions America spends annually on addiction and mental illness (not to mention related areas like special education, public safety, incarceration, homelessness), on top of the lost economic productivity of so many damaged, miserable citizens, a year of universal subsidized parental leave begins to look downright cheap. But developmentally-appropriate leave will never be considered until we first stand up for the importance of dyadic, co-regulating care, especially for small, pre-verbal babies. Intimate, attuned care is what imbues the skill set for wellbeing: emotional self-regulation, an internal locus of control, a realistic sense of self, and a capacity for trusting, bonded relationships.

A real Mommy war should break out if educated working feminists continue to wear blinders about daycare, and thereby enable a society where elite children get artisanal mothering (or its nanny-care facsimile), with 'factory farms' for everyone else. Developmentally-adequate care for all babies is a fundamental social justice issue.

We must have the courage to admit that outsourcing early infancy, while it has benefitted women’s economic viability and corporate bottom lines, has not benefitted kids. We must imagine a feminist solution that puts small children into the lifeboat first.