Time to Think Babies

Matthew Melmed is executive director of ZERO TO THREE. Kristin Schubert is managing director at the Robert Wood Johnson Foundation.


Rachel Upshaw is a full-time working mother in Nashville. She’s a professional with a steady job, but the firm she works at is very small and when Rachel got pregnant it had no paid family leave policy.

As her pregnancy progressed, Rachel was apprehensive about what would happen when she gave birth. Ultimately, she negotiated four weeks of paid maternity leave. Combined with some vacation she’d saved up and a few holidays, Rachel had a total of seven weeks of paid leave.

Rachel advocated for herself at her job because she understood that her daughter Ella needed her and her husband David to be there in the first days and weeks of life. The three of them were building strong relationships, which were nurturing Ella’s development at a time when her brain was building more than one million new neural connections every second. Those relationships are essential for every baby’s long-term health and success and enable Ella to lay the foundation for how she will learn and grow.

After seven short weeks, Rachel was back at work. David’s mother was able to care for Ella a little bit longer, and then Ella started child care at the tender age of 12 weeks old. The Upshaws were fortunate to find a child care center they liked, but they were shocked to find that it costs more than $1,300 per month.

Rachel’s story is all too common. Millions of parents in the United States know exactly what it’s like to have little or no paid leave following childbirth or the adoption of a new child, and how difficult it can be to find high quality, affordable child care. Only 13 percent of workers have access to paid family leave, and in 30 states and D.C., infant care exceeds the cost of in-state public college tuition, putting it out of reach for many families. And yet, despite some of the challenges the Upshaws faced, they are still more fortunate than many.

Nearly half of all babies in the U.S. live in or near poverty, and for them, the stress from things such as poor nutrition or unstable housing can lead to long-term consequences. Poverty can actively hinder brain development, making it harder for toddlers to learn, to build memory and language skills, and to manage their emotions. It can even harm a child’s immune system. Long-term, these early setbacks can lead to everything from lower academic achievement to higher disease rates.

But we cannot simply want or even encourage parents to spend more time with their children; we must invest so that they can. Creating policies and making investments that support strong families not only gets babies off to the healthy start they need to thrive, it’s also good for the economy. Quality early childhood programs that begin at birth can deliver a 13 percent per year return on investment, through more years of education, more employment, and better adult health.

The first week of May, Rachel and Ella — now a precocious one and a half year old — were on Capitol Hill, along with families from every other state and DC, to share their story and help Congress understand how we can help all babies thrive.

First, parents need the time and stability to build strong early relationships with their children. When parents are forced to return to work too early, babies don’t get the time they need to form the close bonds that are so essential to building a healthy brain and body.

Secondly, quality child care should be affordable and accessible to all. Quality choices are out of reach for too many families, and more affordable care can be of lower quality that is detrimental to children’s development. Making quality, affordable care a reality for all families — regardless of socio-economic status — can help all young children get the strong start they need.

Finally, it’s essential to invest in babies’ healthy emotional development. By integrating mental health supports in primary pediatric care offices and early childhood programs, the providers who are closest to young children will have the tools to work with both parents and babies to support healthy emotional development, which is essential for learning and for building strong relationships.

We can’t afford to ignore the critical first few months and years of development. The stakes are too high. Congress should Think Babies and put the next generation of parents and workers, and this country, on the best path possible.