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American Academy of Pediatrics
Special Article

The Rights of Children for Optimal Development and Nurturing Care

Julie Uchitel, Errol Alden, Zulfiqar A. Bhutta, Jeffrey Goldhagen, Aditee Pradhan Narayan, Shanti Raman, Nick Spencer, Donald Wertlieb, Jane Wettach, Sue Woolfenden and Mohamad A. Mikati
Pediatrics December 2019, 144 (6) e20190487; DOI: https://doi.org/10.1542/peds.2019-0487
Julie Uchitel
Division of Pediatric Neurology and
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Errol Alden
International Pediatric Association and Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland;
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Zulfiqar A. Bhutta
Division of Women and Child Health, Aga Khan University, Karachi, Pakistan;Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada;
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Jeffrey Goldhagen
Division of Community and Societal Pediatrics, Department of Pediatrics, College of Medicine, University of Florida, Jacksonville, Florida;
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Aditee Pradhan Narayan
Department of Pediatrics, Duke University Health System, Durham, North Carolina;
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Shanti Raman
International Pediatrics Association Standing Committee, International Society of Social Pediatrics and Child Health, Geneva, Switzerland;Division of Community Pediatric, South Western Sydney Local Health District, Sydney, New South Wales, Australia;
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Nick Spencer
Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom;
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Donald Wertlieb
Eliot-Pearson Department of Child Study and Human Development, School of Arts and Sciences, Tufts University, Medford, Massachusetts;
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Jane Wettach
Duke Children’s Law Clinic, School of Law, Duke University, Durham, North Carolina; and
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Sue Woolfenden
Discipline of Paediatrics, School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Mohamad A. Mikati
Division of Pediatric Neurology andEarly Childhood Development Standing Advisory Group, International Pediatrics Association, St Louis, Missouri;
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Abstract

Video Abstract

Millions of children are subjected to abuse, neglect, and displacement, and millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children’s rights, progress is slow and impeded by political considerations. The United Nations Convention on the Rights of the Child, a global comprehensive commitment to children’s rights ratified by all countries in the world except the United States (because of concerns about impingement on sovereignty and parental authority), has a special General Comment on “Implementing Child Rights in Early Childhood.” More recently, the World Health Organization and United Nations Children’s Fund have launched the Nurturing Care Framework for Early Childhood Development (ECD), which calls for public policies that promote nurturing care interventions and addresses 5 interrelated components that are necessary for optimal ECD. This move is also complemented by the Human Capital Project of the World Bank, providing a focus on the need for investments in child health and nutrition and their long-term benefits. In this article, we outline children’s rights under international law, the underlying scientific evidence supporting attention to ECD, and the philosophy of nurturing care that ensures that children’s rights are respected, protected, and fulfilled. We also provide pediatricians anywhere with the policy and rights-based frameworks that are essential for them to care for and advocate for children and families to ensure optimal developmental, health, and socioemotional outcomes. These recommendations do not necessarily reflect American Academy of Pediatrics policy.

  • Accepted September 19, 2019.
  • Copyright © 2019 by the American Academy of Pediatrics
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Pediatrics
Vol. 144, Issue 6
1 Dec 2019
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The Rights of Children for Optimal Development and Nurturing Care
Julie Uchitel, Errol Alden, Zulfiqar A. Bhutta, Jeffrey Goldhagen, Aditee Pradhan Narayan, Shanti Raman, Nick Spencer, Donald Wertlieb, Jane Wettach, Sue Woolfenden, Mohamad A. Mikati
Pediatrics Dec 2019, 144 (6) e20190487; DOI: 10.1542/peds.2019-0487

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The Rights of Children for Optimal Development and Nurturing Care
Julie Uchitel, Errol Alden, Zulfiqar A. Bhutta, Jeffrey Goldhagen, Aditee Pradhan Narayan, Shanti Raman, Nick Spencer, Donald Wertlieb, Jane Wettach, Sue Woolfenden, Mohamad A. Mikati
Pediatrics Dec 2019, 144 (6) e20190487; DOI: 10.1542/peds.2019-0487
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  • Article
    • Abstract
    • Children’s Rights and the CRC: Global Context
    • Child Rights and the CRC: US Context
    • The NCF for ECD
    • The Neurobiological Justification for the Importance of Nurturing Care in ECD
    • Challenges to Providing Nurturing Care and Ensuring Child Rights in the United States and Globally
    • Specific Recommendations for Pediatric Associations to Address Challenges to the Implementation of Nurturing Care and Child Rights
    • Specific Recommendations for Pediatricians to Address Challenges to the Implementation of Nurturing Care and Child Rights
    • Conclusions and the Way Forward
    • Acknowledgments
    • Footnotes
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