How are Quebec's youngest children faring? A report on the conditions surrounding their birth, physical and mental health and overall development

MONTREAL, November 21, 2017 - The 2017 Portrait produced by the Early Childhood Observatory (Observatoire des tout-petits), entitled How are Quebec's youngest children faring?, describes the conditions surrounding the birth of children between the ages of 0 and 5, their physical and mental health, and their overall development.

This second edition of our annual portrait shows that babies, toddlers and preschoolers, who numbered 534,939 in Quebec in 2016, have generally been coming into the world under better conditions over the past 30 years. Their physical health has also improved during the past decade with respect to asthma, accidental injury and infectious diseases.

Certain aspects continue to give cause for concern, however: the Caesarean birthrate, measles outbreaks, excess weight and obesity, mental health and overall development. The portrait also reveals that a fairly significant number of young children do not have access to a family doctor or pediatrician.

"Our second portrait shines a new light on the state of health and development of the youngest Quebecers, focusing on improvements as well as situations that need to be monitored. It is our hope that this document will incite reflection on possible courses of action that could be collectively implemented to ensure the well-being and healthy development of our very young children. As a society, we have the power to act. The 2017 Portrait also provides several examples of cooperative measures that could have a positive impact on children's lives," explains Fannie Dagenais, Director of the Early Childhood Observatory. 

Several gains in the areas of birth and physical health

Low birth weights and stillbirths have been on the decline since the late 1970s. Progress has also been made in the area of breastfeeding. According to 2013-2014 data, 89% of new mothers breastfed or attempted to breastfeed their youngest child, as compared to 72.6% in 2000-2001. Among mothers who began breastfeeding their babies at birth, however, only 77.3% were still breastfeeding at one month, 61.8% at four months, 54.3% at six months, and 15.3% at one year. The World Health Organization recommends that babies be breastfed exclusively for the first six months of their lives. The data in our portrait suggests that some mothers might need more support with breastfeeding.

In certain aspects of their physical health, very young children are faring better in 2017 than they were 10 years ago. Hospitalizations for asthma among children between 0 and 4 years of age decreased between 2007-2010 and 2013-2016, as did hospitalizations for accidental injuries. Several vaccine-preventable infectious diseases are also on the decline. There have, however, been outbreaks of measles and mumps during the past few years, reminding us of the importance of continuing to ensure that very young children are properly vaccinated.

Significant increase in the number of caesarean births 

It is worrying to note that the Caesarean birthrate rose from 20.9% in 2002 to 24.9% in 2015. Although Caesarean deliveries are sometimes medically necessary, they are not without risk (possibility of infection, haemorrhage, difficulty initiating breastfeeding). There are no data showing that a Caesarean birth has positive effects on the mother or baby when it is not medically required. The international community agrees that the ideal Caesarean birthrate is between 10% and 15%. 

One out of three children affected by weight-related problems
Access to a doctor continues to be difficult for many children

In spite of the progress in many aspects of children's physical health over the past few years, the data on infantile obesity are cause for concern. Between 2012 and 2015, one child out of every three between the ages of 36 and 60 months was at risk of becoming overweight or already was overweight or obese. Moreover, about three-quarters of children between 3 and 5 failed to follow Canadian guidelines for maximum screen time and close to one-third did not respect physical activity guidelines.

Finally, the portrait shows that many children still do not have access to a family doctor or pediatrician. In 2015, almost one family out of ten said they did not have access to a family doctor. Timely access to healthcare is crucial for young children. Delays in receiving care can have a negative impact on their health and quality of life. 

22,010 very young children had been diagnosed with a mental disorder

The mental health of the very young is a situation that needs to be monitored: the number of diagnoses rose from 3.5% to 4.8% between 2000 and 2016. A total of 22,010 children between the ages of 1 and 5 had been diagnosed with a mental disorder, primarily for specific developmental delays or behavioural disorders. Very young children had also been diagnosed with other disorders, such as autism spectrum disorder (ASD), anxiety, depression or ADHD, but in smaller proportions, although ASD and ADHD diagnoses also increased between 2000-2001 and 2015-2016. It is important to note that our data reports only cases that have been diagnosed. Since very little data is available for evaluating the mental health of young children, the extent of the situation may be underestimated.

One out of four children in kindergarten is developmentally vulnerable

Children's overall development is cause for concern: 26% of kindergartners were vulnerable in at least one area of their development in 2012. Of that number, half were vulnerable in more than one development domain. Survey data also showed that certain groups of children are more likely to be vulnerable in at least one area of their development: those who did not regularly attend daycare, those born outside of Canada or whose mother tongue is other than French or English, younger children, boys, and children living in the most materially or socially disadvantaged environments.

Working together to ensure a better future for our children

The scientific literature has documented the existence of collective drivers that we can use to take action in areas that affect young children's health, well-being and overall development-whether it be by improving the socioeconomic environment of the very young, providing better access to healthcare or quality daycare, ensuring better training for professionals, conducting awareness campaigns or offering more support to parents.

Our 2017 Portrait, launched to coincide with Early Childhood Week, is just one of the initiatives of the Early Childhood Observatory aimed at providing reliable data on the current status of children between the ages of 0 and 5 living in Quebec. The indicators presented in this portrait remind us, more than ever, of how important it is to ensure that the development and well-being of the very young remain a priority for Quebec society.

About the observatoire des tout-petits / early childhood observatory

The mission of the Early Childhood Observatory, a project of the Lucie and André Chagnon Foundation, is to help ensure that the development and well-being of Quebec's very youngest children has a place at the top of the province's list of social priorities. To achieve this goal, the Observatory compiles the most reliable and relevant data on 0-5 year-olds which it then disseminates to incite dialogue on possible collective action in this area. For more information on the Early Childhood Observatory, visit: www.tout-petits.org

About early childhood week

Running from November 19-25, 2017, Early Childhood Week provides an opportunity for communicating and inciting dialogue on the subject of young children's well-being and development, highlighting local and regional initiatives that support very young children, and mobilizing Quebec society as a whole. Several activities and events are planned throughout the province during the entire week. To find out more, visit grandesemaine.com.

SOURCE Observatoire des tout-petits

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