In 2023, Gov. Ned Lamont created a Blue Ribbon Panel on Child Care, charging it to come up with a five-year plan to improve access to early care and education, supporting families, care providers, and Connecticut’s economy. This panel is recommending, among other things, an unwise increase in the ratio of children to caregivers.
At present, Connecticut’s regulations meet both federal guidelines and the recommendations of the American Academy of Pediatrics. A caregiver in a child care center can be responsible for no more than four two-year-olds (with no more than eight children in a group). The panel’s recommended policy would increase this to five children per caregiver, with as many as ten children in a group. In a large family home care setting, there can currently be no more than four children per provider; the report would increase this to six children.
The Connecticut Chapter of the American Academy of Pediatrics, which I represent, strongly opposes these changes.
I have over 30 years’ experience as a primary care pediatrician and have been active in the child advocacy work of the Academy of Pediatrics for almost as long. I find the panel’s proposals alarming.
The proposed changes to the ratio of children to caregivers would reduce the quality of care children receive in day care settings. Studies supported by the American Academy of Pediatrics, the American Public Health Association, and the National Resource Center for Health and Safety in Child Care and Early Education have shown than the quality of child care improves when child-to-caregiver ratios are reduced and class sizes are smaller. These children show improved social-emotional development, physical well-being and overall learning. With fewer children and more caregivers in small groups, it is easier to promote the well-being of toddlers.
There were no licensed pediatric professionals on the blue ribbon panel, and it did not use pediatricians as advisors, as speakers, or for technical assistance. This was not due to any lack of interest among pediatricians in the panel’s work and is deeply disturbing.
Pediatricians know very well that many Connecticut families find it very difficult to obtain high quality, affordable day care. One reason for this shortage is the low wages paid to caregivers, resulting in staff shortages. The panel’s recommendation would worsen this shortage by increasing caregiver workloads without increasing their pay.
Rather than reducing the quality of care our state’s children experience, we should be providing subsidies and other funding for child care programs to keep child-to-caregiver ratios and costs to parents low.
On behalf of the over 600 members of the Connecticut Chapter of the American Academy of Pediatrics, I urge our state leaders to reject the panel’s recommendations and instead focus on policies that would benefit our children, their parents, and their caregivers. That would be an investment that pays dividends for us all.
Sandra Carbonari M.D. is a past president of the Connecticut Chapter of the American Academy of Pediatrics.