Primary Caregiving

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Article - Primary Caregiving

Child care provider playing with children.Use this resource to help communicate the importance of primary caregiving. It will help promote essential program practices to ensure quality in family child care and center-based programs that serve infants and toddlers.


High-quality relationship-based care is central to children’s early brain development, emotional regulation, and learning (Center on the Developing Child, 2012). The Program for Infant/Toddler Care recommends six essential program practices as a framework for relationship-based care. One of these practices is primary caregiving—the practice in which the care of each infant or toddler is assigned to one specific caregiver who is principally responsible for caring for that child in the care setting and communicating with the child’s family (Lally & Mangione, n.d.). Consistent, responsive, and meaningful interactions with a primary caregiver build a child’s attachment with a familiar adult (Raikes & Edwards, 2009). Primary caregiving also strengthens relationships with families, which, in turn, supports the development of trust and security between the infant or toddler and the primary caregiver (Lally et al., 2010).

The primary caregiver’s responsibilities include

  • fostering a relationship with the child and his or her family;
  • observing, documenting, and anticipating and planning for each child’s development process and learning;
  • supporting the child through transitions;
  • carrying out the majority of the child’s personal care routines; and
  • providing emotional support.

Primary caregiving does not mean exclusive care. It means, however, that program leaders, caregivers, and families know who has primary responsibility for each child. Primary caregiving often happens naturally in family child care homes (Lally & Mangione, n.d.).

Why Is Primary Caregiving Important for Infants and Toddlers?

  • Primary caregiving relationships provide a strong foundation for responsive interactions and communication between an infant or toddler and his or her caregiver (Ruprecht et al., 2016).
  • Primary caregiving provides opportunities for caregivers to deepen their knowledge of a child’s development, abilities, and interests, which allows for more accurate developmental assessments and individualized curriculum implementation (Theilheimer, 2006).
  • Primary caregiving provides an opportunity for partnerships between families, primary caregivers, and specialists (for example, mental health, medical, occupational therapists) that support individualized care for infants and toddlers (McMullen et al., 2016).

How Does Primary Caregiving Promote Positive Child Outcomes?

  • Infants and toddlers develop trust when primary caregivers respond to their unique temperament, needs, and interests (Copple & Bredekamp, 2009).
  • Primary caregiving supports infants’ and toddlers’ identity and cultural connection to their families (Lally, 1995; Virmani & Mangione, 2013).
  • Responsive primary caregivers buffer stress and help the infant or toddler regulate (National Scientific Council on the Developing Child, 2007).
  • Young children who do not have a primary caregiver and instead experience multiple caregivers (or multiple childcare settings in a day) are more likely to engage in challenging behavior (Clasien de Schipper et al., 2004; Morrissey, 2009).

Planning to Implement Primary Caregiving in Diverse Child Care Settings

Goal: High-quality infant and toddler programs implement primary caregiving for each infant and toddler.

  • Implement written guidance to support primary caregiving throughout the program. This includes creating staff and family handbooks that share the importance of, as well as practices for, supporting primary caregiving strategies for infants and toddlers and their families.
  • Create job descriptions for infant and toddler caregivers that include expectations for primary caregiving practices. This includes forming relationships with families, learning about families’ home cultures and caregiving routines, and weaving the home care experiences into daily practice.
  • Attend, create, or advocate for professional development that promotes primary caregiving.
    • Strengthen professional development of caregivers and administrators on the concepts and implementation of primary caregiving. This should start at orientation when hiring new staff and then continue throughout the years of employment.
  • Use an intentional review process to continually strengthen primary caregiving across the center or family child care program.


Center on the Developing Child. (2012). Executive function: Skills for life and learning [InBrief summary].

Clasien de Schipper, J., Van Ijzendoorn, M. H., & Tavecchio, L. W. C. (2004). Stability in center day care: Relations with children’s well-being and problem behavior in day care. Social Development, 13(4), 531–550.

Copple, C., & Bredekamp, S. (2009). Developmentally appropriate practices in early childhood programs (3rd ed.). National Association for the Education of Young Children.

Lally, J. R. (1995). The impact of child care policies and practices on infant/toddler identity formation. Young Children, 5(1), 58–67.

Lally, J. R., Torres, Y. L., & Phelps, P. C. (2010). How to care for infants and toddlers in groups. Zero to Three.

Lally, J. R., & Mangione, P. L. (n.d.). About the Program for Infant/Toddler Care. WestEd; California Department of Education. Retrieved March 10, 2020, from

McMullen, M. B., Yun, N., Mihai, A., & Kim, H. (2016). Experiences of parents and professionals in well-established continuity of care programs. Early Education & Development, 27, 190–220.

Morrissey, T. W. (2009). Multiple child‐care arrangements and young children’s behavioral outcomes. Child Development, 80(1), 59–76.

National Scientific Council on the Developing Child. (2007). The science of early childhood development: Closing the gap between what we know and what we do.

Raikes, H., & Edwards, C. (2009). Extending the dance in infant and toddler caregiving. Paul H. Brookes Publishing Company, Inc.

Ruprecht, K., Elicker, J., & Choi, J. (2016). Continuity of care, caregiver–child interactions, toddler social competence and problem behaviors. Early Education and Development, 27, 221–239.

Theilheimer, R. (2006). Molding to the children: Primary caregiving and continuity of care. Zero to Three, 26(3), 50–54.

Virmani, E. A., & Mangione, P. L. (Eds.). (2013). Infant/toddler caregiving: A guide to culturally sensitive care (2nd ed.). California Department of Education.