Caretakers, child care practices, and growth failure in highland Ecuador.

Problems for child health have been attributed to child and sibling caretaking. Nevertheless, our data from highland Ecuador suggest an ambiguous relationship between growth failure and the practice of peer care. In a region where levels of chronic undernutrition as measured by stunting exceed 75 percent and fully one-quarter of children under five are underweight, analysis of structured observations of a sample of 28 children reveals no statistical association between growth indices and the practice of older children caring for younger children. Qualitative data, however, indicate that the practice can be a complication in specific cases where children already suffer compromised health. While the advantages or disadvantages associated with particular caretakers appear secondary to the risks attending inadequate diets or the broader environment of rural poverty, the potential for difficulties to emerge from peer care suggests that community day care provides a valuable alternative in this context.