It is important for both workers in daycare settings and parents to know about cortisol.
Cortisol is a hormone that mobilises bodily resources in the face of immediate danger. There is a normal daily variation in cortisol, with high levels observed in the morning and low levels in the evening for young children. This may reflect the establishment of asleep and awake patterns.
It is normal for babies to get anxious and produce cortisol, especially in response to separation, but their ability to reduce the level before it causes problems varies. Over the first year of life children generally learn to dampen their cortisol response to stress, and this is linked to the quality of their care. Toddlers having an insecure relationship with their caregiver show elevated levels of cortisol when upset.
A study that looked at the correlation between cortisol levels and quality of daycare found large increases from morning to afternoon in three- to five-year- olds attending for full days at the poorer quality centres.
Recent research from Australia confirms this, as even medium-quality care produced steady cortisol levels, suggesting low-level stress which could affect development. Unsatisfactory service delivery was associated with increases in cortisol levels, indicating chronic stress and the risk of negative long-term developmental outcomes. Children with more negative temperaments who found emotional regulation hard were the ones who showed the most marked increase in cortisol.
Children who produce higher levels of cortisol during normal days at nursery have a harder time with self-control and sustaining attention. The real problem comes when they take this home at the end of the day, so it is important to educate parents. With an excess of cortisol in their bloodstream these children are fussy, over-active, easily plunged into distress and hard to settle. These are just the sort of 'inexplicable'
behaviours that drive parents to the end of their tether after their own taxing day at work. If giving up work and daycare is impossible, then parents have to be prepared and helped to be the external source of calmness for the child's internal state.
Robin Balbernie is a consultant child psychotherapist in Gloucestershire
