MNAAP Work Group Update: Early Childhood


Early childhood education has been a popular term at the legislature this year! As pediatricians know (and most other people, young parents and legislators included, do not know), early childhood education is the same as early childhood life!  No classrooms needed.  An enormous amount of learning has to take place before any “schooling” or “kindergarten” or even “Pre-K” can succeed.  The first thousand days of health, brain development and learning and life are the focus of the MNAAP Early Childhood Work Group.  

Brain development occurs more consequentially and rapidly in the first 1,000 days than at any other time of postnatal life. Infants and preschoolers learn an enormous set of skills, but doing so is predicated on a strong foundation of relationships.   

Babies must learn to direct their eyes, manipulate their arms and legs, grasp and maneuver objects in their world, and associate the look and feel and scent and taste of literally everything. As they get older, sitting up, rolling over, standing, walking, running, and turning somersaults all must be mastered. And that’s before learning the meaning of hundreds of words and how to say them.  And all must be remembered for later use. What a wonderful organism that can accomplish all this in three to four years and in any language. (Sometimes more than one!)

But none of it can be accomplished alone. Early childhood “teachers” are parents and grandparents, and siblings and paid childcare providers—adults with an eye to the child’s developmental stage and needs and a consistent presence throughout.   And perhaps more important, the brain cells and synapses that are not assigned a task and used repeatedly begin to be removed, “pruned”, toward the end of that same 1000 days—never to be available again! 

Our Early Childhood Work Group wants to support you by collecting the practices, skills and knowledge to better empower families, educators and legislators to do the important work of early childhood support. To this end, we have started a lecture series on early childhood,  bringing the newest science and best thinkers on topics such as autism identification, early brain development and trauma response.  You can see those lectures on the MNAAP website ( Moreover, we have had a big presence at the legislature that belies the size of our patients, conveying the importance of the following topics:

We want to support the ability of families to be at baby’s side in the early critical period as well as consequential moments such as times of illness. This is why we have been supportive of Paid Family Medical Leave.

We have been ardent supporters of programs such as home visiting, Reach out and Read and Early Childhood Family education that promotes early learning and interaction.

Currently, our childcare “system” is lacking about 40 percent of the early childhood educators that it needs.  Many families cannot find childcare at an affordable price if at all.  And parents are forced to stay home and forgo some of the income they badly need. Advocating for childcare reform is imperative. 

The Early Childhood Working Group would like to enlist you—as members of MNAAP, and as educators for the children and parents in your practices.  Legislators need to hear your voice.  Parents and families need your guidance and advice at every early childhood visit.  Your local schools and childcare settings need your attention and support. 

Please contact the chairs or members of the group to offer your advice and participation. 

Early Childhood Work Group Co-Chairs:

Nate Chomilo, MD, FAAP (

Krishnan Subrahmanian, MD, MPhil, DTM, FAAP (

Roger Sheldon, MD, FAAP ( 

Annual Sponsors

Children's Minnesota
Gillette Children's
Hennepin Healthcare
University of Minnesota Health
Essentia Health
Mayo Clinic
Shriners Healthcare for Children-Twin Cities