Recommendation 4 — Decision makers at all levels of government, as well as leaders from the business community, should ensure that better public and private policies provide parents with viable choices about how to allocate responsibility for child care during the early years of their children's lives. During infancy, there is a pressing need to strike a better balance between options that support parents to care for their infants at home and those that provide affordable, quality child care that enables them to work or go to school. This calls for expanding coverage of the Family and Medical Leave Act to all working parents, pursuing the complex issue of income protection, lengthening the exemption period before states require parents of infants to work as part of welfare reform, and enhancing parents ' opportunities to choose from among a range of child care settings that offer the stable, sensitive, and linguistically rich caregiving that fosters positive early childhood development.
Recommendation 5 — Environmental protection, reproductive health services, and early intervention efforts should be substantially expanded to reduce documented risks that arise from harmful prenatal and early postnatal neurotoxic exposures, as well as from seriously disrupted early relationships due to chronic mental health problems, substance abuse, and violence in families. The magnitude of these initiatives should be comparable to the attention and resources that have been dedicated to crime prevention, smoking cessation, and the reduction of teen pregnancy. They will require the participation of multiple societal sectors (e.g., private, public, and philanthropic) and the development of multiple strategies.
Recommendation 6 — The major funding sources for child care and early childhood education should set aside a dedicated portion of funds to support initiatives that jointly improve the qualifications and increase the compensation and benefits routinely provided to children's nonparental caregivers. These initiatives can be built on the successful experience of the U.S. Department of Defense.
Profound social and economic transformations are posing serious challenges to the efforts of parents and others to strike a healthy balance between spending time with their children, securing their economic needs, and protecting them from the many risks beyond the home that may have an adverse impact on their health and development.