A government document, called, in 1984 style double-speak ‘More Great Childcare’ is suggesting that it is fine to increase staff-child ratios for childminders and nurseries. This is a huge worry to many who work with children and families, and particularly those who work in the area of infant and child mental health. The proposals have sparked a huge wave of protest, including one petition which quickly attracted over 20,000 signatures
Of course if ratios are higher then more children can be placed in nurseries and more cheaply. Indeed it seems that cost is a big driver. However what is left out is the effects on children’s emotional health. In particular what this kind of policy risks is the important need for each child to be in a secure attachment relationship, upon which their psychological health depends. This is something that Penelope Leach and others have been campaigning for for a long time . The bigger the ration the less likely that each child will genuinely have enough attention to feel at ease and thrive, the less they are properly ‘held in mind’ and the more anxious and stressed they become.
Much research has already shown how stress hormones rocket on starting daycare, compared to children who are at home . We also know that nurseries that really take on board the lessons from attachment theory are extremely rare, and to do this one needs very highly trained and sensitive staff, and in addition one needs good staff-child rations. It is worth remembering that in such studies the children showed little outward sign of stress or anxiety, which is maybe why nursery staff often re-assure parents that their children are ‘just fine’.
There is a lot of research about such issues. For example even securely attached children who had been in childcare longer were more hostile in structured interactions with their mothers at 42 months, and were rated by teachers as more aggressive . The differences might be small but are still significant. Children who enter low quality nursery care earlier are more likely to be rated as distractible and less task oriented at pre-school than children who enter nurseries later . Lamb  found that children in day-care were more likely to have an avoidant attachment than those being looked after at home, even if statistically the difference between the 2 groups was not huge. Belsky  in particular has amassed much research from the largest ever study of childcare in the United States suggesting that longer hours in childcare have a persistent effect, which is not massive, but is real and measurable, such as more externalizing problems. Poor childcare though, and high ratios, has a particularly worrying effect.
Attachment needs just cannot be met in large group contexts. Workers in group childcare rarely become substitute mothers. Analysis of over 2000 cases found that, more often than not, in nurseries attachments were of an avoidant or ambivalent rather than a secure kind . Most of the children studied had secure relationships with their mothers. Even though some sensitive and well trained nursery workers can potentially be more sensitive than many parents, even the most sensitive staff-member inevitably becomes less sensitive when activity is geared to the needs of the group as a whole, rather than to specific children. It might be for this reason that secure attachments are more common when childcare is provided in home-based settings, such as by nannies and childminders, presuming that the childminder’s ratios are small enough!.
Peter Elfer  has undertaken detailed observational research in nurseries, in order to bring the child’s perspective more centrally into view. He has described the contrasting experiences of children in nurseries where emotional understanding and attachment is or is not central to the practice and philosophy of the institution. Nursery life is often characterised by a lack of ‘mind-mindedness’ which may be as much a function of working in such an institutional setting as the psychological capacities of the workers. Such studies illustrate some of the difficulties that toddlers have to manage when their childcare environment is less than ideal. Nursery care has generally as yet not taken on-board the lessons from attachment theory, particularly the benefits of developing an attachment relationship with a known and trusted worker who can buffer anxiety levels in very young children . Elfer’s research clearly illustrates the very different experiences children have when a nursery is run with an awareness of attachment issues and a child’s emotional needs.
As Penelope leach and other have pointed out, the pressure on parents is currently huge, many have little option but to go out to work, but this is a new phenomenon. In leach’s recent study, the largest ever conducted in the UK, by far the majority of mother’s who were seeking childcare had not been in such childcare in their own childhoods. This in itself might be seen as a worrying enough trend, but the increase in rations can only make things worse.
 P. Leach, Child Care Today. Cambridge: Polity Press, 2009.
 L. Ahnert, M. R. Gunnar, M. E. Lamb, and M. Barthel, ‘Transition to child care: Associations with infant–mother attachment, infant negative emotion, and cortisol elevations’, Child Development, vol. 75, no. 3, pp. 639–650, 2004.
 B. Egeland and M. Hiester, ‘The long-term consequences of infant day-care and mother-infant attachment’, Child Development, vol. 66, no. 2, pp. 474–485, 1995.
 A. Hungerford and M. J. Cox, ‘Family factors in child care research’, Evaluation Review, vol. 30, no. 5, pp. 631–635, 2006.
 M. E. Lamb, ‘Effects of nonparental child care on child development: an update’, Canadian Journal of Psychiatry, vol. 41, no. 6, pp. 330–342, 1996.
 J. Belsky, D. L. Vandell, M. Burchinal, K. A. Clarke-Stewart, K. McCartney, and M. T. Owen, ‘Are there long-term effects of early child care?’, Child Development, vol. 78, no. 2, pp. 681–701, 2007.
 L. Ahnert, M. Pinquart, and M. E. Lamb, ‘Security of children’s relationships with nonparental care providers: A meta-analysis’, Child Development, vol. 77, no. 3, pp. 664–679, 2006.
 P. Elfer, ‘Exploring children’s expressions of attachment in nursery’, European Early Childhood Education Research Journal, vol. 14, no. 2, pp. 81–95, 2006.
 R. Bowlby, ‘Babies and toddlers in non-parental daycare can avoid stress and anxiety if they develop a lasting secondary attachment bond with one carer who is consistently accessible to them’, Attachment & Human Development, vol. 9, no. 4, pp. 307–319, 2007.