Physical

care routines for babies and children

It is very important that early years practitioners understand the
importance of providing respectful physical care for babies and young
children which takes into account their ability, culture, and personal
preference. Any religious practices or family traditions must also be
carefully considered. It is essential that we work closely with the
parents of the children and that we respect their knowledge and
decisions about their own child at all times.

Before we can start to care for babies and children we need to seek the
opinions and preferences of their parents or other carers so that we can
be certain that we are taking their wishes into account. For example do
they want their child to have a dummy or other comforter when they go
to sleep? Do they wish a barrier cream to be applied at every nappy
change? In order to provide for a child’s physical care we need to work
closely with their parents.

Areas of physical care for babies and young children include:

v Skin
v Hair
v Teeth
v Nappy changing
v Toilet training

Skin

If the skin is not cared for correctly infections can enter the body. It is
therefore important that early years practitioners encourage children to
keep their skin clean. Babies and young children will need to have their
hands and faces washed often throughout the day. Babies in particular
are prone to putting their hands in their mouths often and as a result
they may introduce infection. Babies and young children will learn
routines over time providing they are systematic and effective. Making
 CACHE Level 3 Award in Childcare and Education

sure that children learn from an early age the importance of washing
hands before eating is very important. There may be times, in an early
years setting that you may need to bath a baby, perhaps they have
vomited or have been taking part in messy play activities. Again it is
important to check with parents that they have no objection to this and
to enquire what products, if any, are used at home. Some children are
prone to skin infections and certain products may result in the condition
flaring up.

In addition to ensuring
that babies and young
children’s skin is kept
clean it is also important
that early years
practitioners understand
the importance of
ensuring that skin is
protected from the sun.
The skin of babies and
young children is very sensitive and as a result will burn easily. Exposure
to the sun can cause skin cancers and therefore it is vital that protection
is used. Ideally babies and young children should be kept out of the sun
altogether and kept in the shade. However, even when in the shade,
skin can still burn. Parents should be asked to provide their children
with a sun hat and suitable sun cream which should be applied regularly.
It is important to remember that sun cream goes out of date and
therefore early years practitioners should be careful to check dates and
ask parents to replenish when necessary. A sun protection policy should
be in place in the early years setting and it is vital that applications are
made regularly, particularly when children are playing in water, and
these are recorded.

You can find more information regarding skin care in the sun by visiting
www.sunsmart.org.uk – a website giving advice about protecting babies
and children which is run by Cancer Research.

2

 CACHE Level 3 Award in Childcare and Education

Hair

It is not usually the job of an early years practitioner to style children’s
hair however, in some cases this may be necessary as children’s hair can
often become untidy through the course of the day. Always check with
parents whether they use a brush or comb and, if possible, as them to
provide hair tools. Some children will require hair oils rather than
shampoos. It is worth looking out for children who:

v Scratch their heads/scalps frequently
v Appear to have ‘dandruff’ which does not move
v Have objects moving in their hair

All three of the above are indications that a child may have head lice.
The ‘dandruff’ may be egg cases, known as nits and anything moving in
the hair could be lice.



Head lice can be treated in a variety of ways including:

v The use of chemical solutions available from pharmacists
v Combing them out
v Using an electrical comb

If there is an outbreak in your setting it is important that the parents of
all the children are informed so that they can check their children.
Adults should also be treated as head lice spread quickly from one head
to another.

Teeth

Routine care of teeth should begin as soon as the first tooth appears.
Babies and young children should have their teeth brushed by an adult
and older children should be supervised to ensure that effective

3

 CACHE Level 3 Award in Childcare and Education

brushing is carried out. Each child should have their own tooth brush
and this should be replaced regularly. Children should be encouraged to
brush their teeth in a morning and evening and after meals.

A baby’s first teeth, known as milk teeth, usually start to develop whilst
the child is still growing in the mother’s womb. In most cases, these
teeth start to emerge when the child is around six months of age
however it is important to remember that all children are different and
some babies may be born with teeth whilst others can develop them as
young as four months or after twelve months.

Some babies experience little or no pain at all whilst others can be
troubled with teething pain, sore and red gums.

Nappy changing

Most early years settings insist that parents provide nappies for their
child. This is mainly because parents will undoubtedly have their own
preference when it comes to choosing nappies and this may be the
disposable variety – of which there are many on the market – or the
cloth variety. Inevitably cloth nappies will need changing more
frequently than disposable nappies as they are much less absorbent
however, parental preference should be respected. Hygiene procedures
to prevent cross –infection should be followed at all times and the use of
protective gloves and aprons when changing nappies is essential. Dirty
nappies should be disposed of immediately in accordance with the
setting’s procedures and all areas thoroughly cleaned so that it is ready
for the next child to be changed.

Toilet training

Toilet training is a very personal area of physical care and one which can
be fraught with problems for the child, the parent and the practitioner.
Often parents expect children to come out of nappies in a matter of days
when, in reality, this can take weeks and sometimes months. Parents

4

 CACHE Level 3 Award in Childcare and Education

may ask for your advice and it is important to remember that there is no
hard and fast rule when taking this important transition into account.
Some children may have mastered going to the toilet before they reach
two years of age whereas others may be nearer four. As with all aspects
of childcare, for this area to be a success it is important that early years
practitioners work closely with parents.

Never put pressure on a child to come out of nappies and encourage
parents to accept that ‘accidents’ are inevitable. Timing is crucial when
deciding if a child is ready to toilet train. Too early will result in the child
becoming stressed and too late may affect their self esteem. There are
signs which parents and early years practitioners should be looking out
for and sharing with each other which show that a child may be ready to
move from nappies to the potty/toilet and these are:

v Extended periods of time when the child’s nappy is dry
v Communicating the need for a bladder or bowel movement
v Showing an interest in what the potty/toilet is for

It is very important when carrying out the process of toilet training that
early years practitioners work closely with
parents so that the same, or very similar,
methods are used. For example:

v Is the child using a potty at home or going
straight onto the toilet?
v How are ‘accidents’ dealt with? It is very
important that children are not made to feel
guilty if they have an accident. Likewise, if
they ask for the potty/toilet but cannot
‘perform’ they must not be made to feel as if
they have wasted your time.
v What rewards or encouragement are used? Some parents/setting
use training charts and stickers to reward children however it is
important to ensure that these do not put added pressure on a child.

5

 CACHE Level 3 Award in Childcare and Education

Rest and sleep needs

Children can vary enormously in their sleep requirements and it is
therefore very difficult to state the average amount of rest or sleep
required. It is important to remember that all children are different and
therefore we should look for signs of tiredness in addition to monitoring
how much sleep a child gets.

The chart below gives an indication of how much sleep a child of a set
age might require over a 24-hour period.

AGE DAY TIME NIGHT TIME
One week 8 hours 8.5 hours
Four weeks 6.75 hours 8.75 hours
Three months 5 hours 10 hours
Six months 4 hours 10 hours
Nine months 2.75 hours 11.25 hours
Twelve months 2.5 hours 11.5 hours
Two years 1.25 hours 11.75 hours
Three years 1 hour 11 hours
Four years 11.5 hours
Five years 11 hours
Six years 10.75 hours
Seven years 10.5 hours


Using the table above it is easy to average out the sleep requirements
between age groups. For example if you needed to know how much
sleep a child of six weeks requires you would look at how many hours a
child of four weeks (15.5 hours) requires above and then the next stage
of three months (15 hours) and make a reasonable assumption that a
child in between these ages will require around 15 hours sleep.

6

 CACHE Level 3 Award in Childcare and Education

Individual rest patterns

Each child will sleep a different amount and their own personal
preference should be taken into account wherever possible. This will
include the preference of the child as well as their parent/carer as
certain children may require more or less sleep than average. By logging
the rest patterns of younger children you can show their parents how
long each has slept for, ensure that this is understood and that parents
are happy with sleeping patterns. There are a wide range of different
things that can help children to rest including:

v Listening to music
v Enjoying quiet time
v Sharing a book with an adult
v Drawing, colouring or sticking activities
v Playing a quiet game (e.g. a jiqsaw, sleeping lions etc)
v Sitting on cushions and chatting with adults

7

 CACHE Level 3 Award in Childcare and Education

Sudden Infant Death Syndrome

Sudden infant death syndrome (SIDS) – also known as cot death – is the
sudden, unexpected and unexplained death of an apparently well baby.

In the UK, at least 300 babies die suddenly and unexpectedly every year.
This statistic may sound alarming, but SIDS is rare and the risk of any
baby dying from it is low. Most deaths happen during the first six
months of a baby’s life. Infants born prematurely or with a low
birthweight are at greater risk, and SIDS is also more common in baby
boys. Most unexpected deaths occur while the child is asleep in their cot
at night. However, SIDS can also occur when a baby is asleep during the
day or, occasionally, while they are awake. Parents can reduce the risk of
SIDS by not smoking while pregnant or after the baby is born, and
always placing the baby on their back when they sleep.

What causes SIDS?

No-one knows exactly what causes SIDS, but it is thought to be the result
of a combination of factors. Experts believe SIDS occurs at a particular
stage in a baby’s development, and that it affects babies who are
vulnerable to certain environmental stresses.

This vulnerability may be due to being born prematurely or to low
birthweight, or other reasons not yet identified. Environmental stresses
could include tobacco smoke, getting tangled in bedding, a minor illness
or having a breathing obstruction.

Babies who die of SIDS are thought to have problems in the way they
respond to these stresses and how they regulate their heart rate,
breathing and temperature. Although the cause of SIDS is not fully
understood, there are things you can do to reduce the risk.

8

 CACHE Level 3 Award in Childcare and Education

What can I do to help prevent SIDS?

Follow the advice below to help prevent SIDS:

v Place your baby on their back to sleep, in a cot in the room with you.
v Don't smoke during pregnancy or let anyone smoke in the same room
as your baby.
v Don't share a bed with your baby if you or your partner smoke or
take drugs, or if you have been drinking alcohol.
v Never sleep with your baby on a sofa or armchair.
v Don't let your baby get too hot or too cold.
v Keep your baby’s head uncovered. Their blanket should be tucked in
no higher than their shoulders.
v Place your baby in the "feet to foot" position (with their feet touching
the end of the cot or pram).
v If possible, breastfeed your baby.













Equal opportunities

Early Years professionals need to be aware of what the term ‘equal
opportunity’ means and how they can introduce equality and diversity
into their setting. Treating children ‘equally’ does not mean treating
them the same. Children are not all the same: they are individual,

9

 CACHE Level 3 Award in Childcare and Education

unique human beings and as such they have a right to be treated as

individuals with equal concern. Equal opportunity means ensuring that
all children have equal chances to play, develop and enjoy regardless of
their ethnic origins, cultural background, gender, age, family grouping or
disability, and every child must be treated fairly and equally.

Early Years professionals need to ensure that their knowledge about
different cultural groups, disabilities and family set-ups are up to date,
and they will need to look closely at their own attitudes towards people
who are different to themselves.

The laws in the UK deal effectively with overt discrimination which
results from prejudice. Early Years Professionals need to know how to
work in an inclusive way and how to understand and promote equality
of opportunity.

In order to effectively promote diversity, equality and inclusion it is
necessary for Early Years Professionals to know how to:

v Value cultural diversity and respect the differences between families
v Ensure that children have access to individual support
v Have an awareness of different religions
v Promote a sense of belonging
v Avoid stereotypes
v Include children with disabilities and provide support when necessary
v Be aware of the different gender roles and promote alternatives to
the traditional roles
v Work as a team and help to support and promote equal rights

Equality and inclusion are words which are frequently used in the early
years setting and it is important that Early Years Professionals are aware,
not only of their meaning, but also how to put them into practice. The
principles are of little importance if they are not implemented and
managed. Mission and policy statements, after all, are only so many
words if not enacted.

10

 CACHE Level 3 Award in Childcare and Education

Equality does not automatically mean that all children have the same
learning experiences as this may not be appropriate. What it does mean,
however, is that all children should be given the same opportunities to
learn and be included in the setting, and that the activities on offer
should be designed to meet the individual learning needs of each child.
The Early Years professional needs to be aware of how to adapt
activities so that every child, regardless of their ability and stage of
development, can have an equal chance of learning.

It is the job of the Early Years professional to build on the existing
knowledge, skills and understanding of each individual child and to
adapt their environment, activities and experiences to take these into
account.

In order for an Early Years professional to fully understand and promote
equality of opportunity they must:

v Have the confidence to report all incidents of discrimination
v Keep up to date with relevant training
v Know how to access support when necessary
v Be reflective on their own practice and work to improve when
necessary

There may be times when you are caring for a disabled child or one who
has special educational needs that you will need to bring in specialist
advice or equipment. It is important for Early Years professionals to talk
to parents/carers about these additional resources and work together in
order to come to a suitable solution. Early Years professionals need to
ensure that they make sufficient time for all of the children in the
setting, regardless of whether one particular child may temporarily need
more time devoted to them, such as if they are new to the setting or
experiences difficult or emotional times. For Early Years professionals to
fully meet their obligations for inclusion and diversity within the setting,
it is important that the children feel welcome and accepted, that they
are understood and that they feel they belong. A sense of belonging is

11

 CACHE Level 3 Award in Childcare and Education

vital to the care and Early Years professional needs to completely

understand the children they are caring for and to ensure that
colleagues are of the same mind.

As previously mentioned children should be treated fairly and with equal
concern, regardless of their race, religion or ability. It is important that
Early Years professionals bear this in mind during the course of their
work regardless of how the child thinks, what they say or what type of
family background they come from. Assumptions should never be made
because of the way the child has been brought up, whether they come
from an affluent or poor background or whether they have a disability.
All children have the right to be listened to and to have their
contributions valued.

Early Years professionals can encourage children to acknowledge and
accept others and to feel proud of who they are by using activities and
experiences to enable the child to explore who they are and why they
are unique. This can be done in a number of ways including:

v Make a ‘special book’ containing information all about themselves.
This could include pictures or photographs showing the child’s life
from birth to present day and may show their parents/carers and
siblings. Children should be encouraged to talk about their family life
in a positive way and race and religion can be discussed.
v Encourage the children to talk about impending family occasions such
as forthcoming weddings or birthdays. This can be a fantastic way of
introducing other cultures to the setting, as often celebrations of this
kind can differ enormously between cultures.
v Talk about where we live and encourage the children to explore the
different kinds of houses people live in.
v Encourage the children to feel they belong by talking about the child
care family. This consists of all the children in the setting who make
up the special family where everyone is welcome and loved, and their
opinions are valued and respected.

12

 CACHE Level 3 Award in Childcare and Education

It is the responsibility of every Early Years professional in the United

Kingdom to be aware of and have a basic understanding of The United
Nations Convention on the Rights of the Child. The Convention was
approved by the United Nations (UN) in November 1989 and it was
agreed by the UK government in December 1991 to uphold it. This
means that the UK, along with all the other countries that have ratified
the Convention are legally bound to it to do what it states and to make
all laws, practice and policy compatible with the Convention.

There are 54 articles in the UN Convention on the Rights of the Child and
Article 32 states that:

“All children have a right to relax and play, and to join in a wide range of
activities”.

Although adults should be available to support and extend a child’s play,
learning and development, it is important that they understand when to
intervene in a child’s play and when to step back and observe.












Children should, wherever possible, be allowed to choose and explore
play opportunities themselves in order that they can self-select. They
should be allowed freedom without interruption to enjoy play in their
own time and in a manner than they choose. It can sometimes be
difficult for Early Years professionals to know when to become involved

13

 CACHE Level 3 Award in Childcare and Education

and when to watch and experience will definitely be beneficial when

making these kinds of decisions. Children can often be self-conscious
however, when engrossed in play they lose these feelings and can often
be observed in a completely different light. It is during these times that
Early Years professionals should participate in child’s play only when
they are invited to do so by the child or children or if a situation should
arise whereby a child may be in danger either physically or emotionally.

It is always important that, as all children are different, so too are their
needs and it is the role of the Early Years professionals to be aware of
and respect the individual needs of each child. Whilst some children
thoroughly enjoy, and actively request, the participation of an adult
during play, other children will visibly shy away from such intervention.
It can at times be difficult for Early Years professionals, particularly those
working with children who are grouped together according to age rather
than their interests or similarities, to meet the needs of all the children.
Difficult it certainly may be, however, it is not impossible. The key is to
respect the child. By showing respect you will not only build on the
child’s confidence you will encourage them to trust you which will, in
turn, develop a starting point that will make it easier for you to provide
for the child’s intellectual, emotional and physical needs.

There are a number of important issues that Early Years professionals
need to remember. When providing and supporting a child in play, Early
Years professionals need to:-

v Ensure that the environment is stimulating, exciting and welcoming
v Ensure that children have access to both the indoor and outdoor
areas
v Provide a good mix of structured and planned activities
v Support and extend play in order to encourage learning

14

 CACHE Level 3 Award in Childcare and Education

When providing and supporting a child in play Early Years professionals

must avoid:

v Having unrealistic expectations of children
v Restricting children with regard to choice
v Preventing children from making mistakes

Early Years professionals can assist children in play by providing lots of
opportunities for then to talk to and interact with adults whilst taking
part in interesting and stimulating activities. Research has proved that
play is an essential part of a child’s learning and promotes all areas of
their development.

15