The US routinely fails its babies — Here’s how to fight for their future

If ever any group needed policymakers to do the right thing, it is infants and toddlers. 

But sadly, the United States regularly fails them by consistently refusing to advance a national policy agenda that will help them thrive. This was true before the pandemic, and it remains so today. As we look ahead to a post-pandemic future, we must finally make our youngest children a national priority.  

Each of the 11.4 million infants and toddlers in the United States — more than half of whom are Black, Indigenous, or people of color — has unlimited potential, but we start chipping away at that potential even before they are born. 

This country has one of the highest infant and maternal mortality rates among industrialized nations in the world. Only half of infants and toddlers have a comprehensive medical home — an ongoing, team-based approach to primary care that addresses developmental and family care. Significant percentages of young children live in poverty, lack safe housing, or grow up in households experiencing food insecurity. And on every one of these metrics, children of color and those from families with low incomes shoulder a disproportionate burden. 

The pandemic has exposed and in some cases exacerbated this situation, and the need for policy solutions to correct these injustices has only grown more urgent. The time to act is now.  

The fourth annual State of Babies Yearbook, released recently by ZERO TO THREE, makes clear that the pandemic has made a painful reality even worse for too many young children.

Prior to the pandemic, 40 percent of babies were growing up in families with low incomes. Those gaps widened over the past two and a half years: More than 4  in 10 low-income families with young children saw their income decrease in 2021, compared to roughly 2 in 10 higher-income families.  

Families began to return to non-parental child care last year, but families with low incomes had the hardest time accessing and affording care outside the home. The federal Child Care and Development Fund helps families pay for critically important care. Yet fewer than 5 percent of families who could most benefit from this support actually get it. The combination of economic challenges and limited access to care have affected mental health as well, with families reporting lower levels of emotional support and higher levels of loneliness and emotional distress since the pandemic began. 

The need for additional and more consistent economic support has never been clearer, but we have not met the moment. The American Rescue Plan Act expanded the Child Tax Credit, increasing the credit to up to $3,600 per child for our youngest children and ensuring that families with no and low wages could receive the full amount. During the final six months of 2021, thanks to advance monthly payments, more than 3 million children were lifted out of poverty. Research shows that the impact on poverty would be even greater over the course of a full year, and the upfront investment would more than pay for itself.  

But the same children lifted out of poverty in 2021 fell right back in early in 2022 as the monthly payments stopped. It is simply unfathomable that Congress has not been able to reach an agreement to extend the enhanced federal credit, while a mere six states offer their own. But this failure is emblematic of our usual pattern: expanding help temporarily during an emergency, only to prematurely yank that help away when a threat is perceived to have passed.  

Even during a global pandemic, when the ability to see a doctor and afford basic healthcare has never been more important, 12 states that are home to more than 3.6 million babies have still failed to expand their Medicaid programs under the Affordable Care Act — despite Medicaid’s proven ability to improve access to quality care for both children and adults.  

Equally distressing is our inaction on paid family and medical leave and paid sick days. The science is clear that bonding time for a newborn and parent puts a baby on a path to positive cognitive, physical and mental health. While 10 states have implemented their own paid leave programs, the United States is the only wealthy country not to guarantee paid family and medical leave to all of its workers nationally. 

Furthermore, in the first year of life, an infant has about nine doctor visits for routine and preventive care, barring any visits to treat illnesses. The ability to care for a newborn or take your baby to the doctor should not be a privilege. Yet, nearly two-thirds of lower-income workers do not receive a single paid sick day at all. The end result is that millions of families in the United States are left to fend for themselves.  

When my children were young, I couldn’t imagine ignoring their cries; every parent knows that feeling. But as these examples illustrate, our nation’s policymakers have done just that for far too long. We can’t let that continue. Too many families in our nation do not have the support and resources necessary to help their children reach their full potential.

The problems are well-documented, and the solutions are not a secret. Our children depend on grownups. Whether and how we respond is up to us.     

Miriam Calderón is chief policy officer for ZERO TO THREE and the former deputy assistant secretary for early learning at the U.S. Department of Education. Twitter: @miriamelena88