<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1414-3283</journal-id>
<journal-title><![CDATA[Interface - Comunicação, Saúde, Educação]]></journal-title>
<abbrev-journal-title><![CDATA[Interface (Botucatu)]]></abbrev-journal-title>
<issn>1414-3283</issn>
<publisher>
<publisher-name><![CDATA[UNESP]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1414-32832007000100021</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Shared care: negotiations between families and professionals in a child day care center]]></article-title>
<article-title xml:lang="pt"><![CDATA[Cuidado compartilhado: negociações entre famílias e profissionais em uma creche]]></article-title>
<article-title xml:lang="es"><![CDATA[Cuidado compartido: negociaciones entre familias y profesionales de una guardería]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maranhão]]></surname>
<given-names><![CDATA[Damaris Gomes]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sarti]]></surname>
<given-names><![CDATA[Cynthia Andersen]]></given-names>
</name>
<xref ref-type="aff" rid="A02"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ventura]]></surname>
<given-names><![CDATA[Carolina Siqueira Muniz]]></given-names>
</name>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Universidade Santo Amaro  ]]></institution>
<addr-line><![CDATA[São Paulo SP]]></addr-line>
</aff>
<aff id="A02">
<institution><![CDATA[,Universidade Federal de São Paulo departments of Preventive Medicine and Social Sciences ]]></institution>
<addr-line><![CDATA[São Paulo SP]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2007</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2007</year>
</pub-date>
<volume>3</volume>
<numero>se</numero>
<fpage>0</fpage>
<lpage>0</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://socialsciences.scielo.org/scielo.php?script=sci_arttext&amp;pid=S1414-32832007000100021&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://socialsciences.scielo.org/scielo.php?script=sci_abstract&amp;pid=S1414-32832007000100021&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://socialsciences.scielo.org/scielo.php?script=sci_pdf&amp;pid=S1414-32832007000100021&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Based on a case study of a qualitative nature, this text analyzes the relationship between families and professionals in a child day care center in the process of sharing care during early childhood, using the techniques of observation, interviews and document analysis. The research studied the families and the professionals of a government-run day care center in the city of São Paulo. The conflicts between these social actors became evident, mainly, with regard to care related to feeding and hygiene. The task of sharing care demands from these professionals not only technical preparation, but training in listening to children and their families while taking their uniqueness into account, a requirement that can lead to reflections on the type of care that is most appropriate for the specificity of the group in question, considering the characteristics of locality in its historical and social context.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Com base em um estudo de caso, de natureza qualitativa, analisa-se a relação entre família e profissionais de creche no processo de compartilhar cuidados na primeira infância, utilizando técnicas de observação, entrevistas e análise de documentos. Os sujeitos da pesquisa foram os familiares e os profissionais de uma creche pública na cidade de São Paulo. Os conflitos entre esses atores sociais evidenciam-se, sobretudo, nos cuidados com a alimentação e a higiene. Além do preparo técnico, a tarefa de compartilhar cuidados demanda, dos profissionais a formação no sentido da disposição para escutar as crianças e suas famílias em sua alteridade, exigência esta que abre a possibilidade de um espaço de reflexão sobre o cuidado mais adequado para a especificidade do grupo em questão, considerando as características da localidade, em seu contexto histórico e social.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Basado en un estudio de caso, de naturaleza cualitativa, este texto busca analizar la relación entre familia y profesionales de una guardería en el proceso de compartir cuidados en la primera infancia, utilizando técnicas de observación, entrevistas y análisis de documentos. Los sujetos de la investigación fueron las familias y los profesionales de una guardería en la ciudad de São Paulo. Los conflictos entre estos agentes sociales se evidencian, sobre todo, en los cuidados con la alimentación y la higiene. Además de preparación técnica, la tarea de compartir cuidados exige de los profesionales la capacitación en el sentido de la disposición para escuchar a los niños y sus familias en su alteridad. Esta exigencia abre, entonces, la posibilidad de un espacio de reflexión sobre el cuidado adecuado a la especificidad del grupo en cuestión, considerando las características locales, en su contexto histórico y social.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Child rearing]]></kwd>
<kwd lng="en"><![CDATA[Child day care centers]]></kwd>
<kwd lng="en"><![CDATA[Child care]]></kwd>
<kwd lng="en"><![CDATA[Pediatric nursing]]></kwd>
<kwd lng="en"><![CDATA[Family]]></kwd>
<kwd lng="pt"><![CDATA[Educação infantil]]></kwd>
<kwd lng="pt"><![CDATA[Creches]]></kwd>
<kwd lng="pt"><![CDATA[Cuidado da criança]]></kwd>
<kwd lng="pt"><![CDATA[Enfermagem Pediátrica]]></kwd>
<kwd lng="pt"><![CDATA[Família]]></kwd>
<kwd lng="es"><![CDATA[Educación en la primera infancia]]></kwd>
<kwd lng="es"><![CDATA[Guardería]]></kwd>
<kwd lng="es"><![CDATA[Cuidado del nino]]></kwd>
<kwd lng="es"><![CDATA[Enfermería Pediátrica]]></kwd>
<kwd lng="es"><![CDATA[Familia]]></kwd>
</kwd-group>
</article-meta>
</front><body><![CDATA[ <p><font face="verdana" size="4"><a name="_ftnref1"></a><b>Shared care: negotiations    between families and professionals in a child day care center<a href="#_ftn1"><sup>*</sup></a></b></font></p>     <p>&nbsp;</p>     <p><font face="verdana" size="3"><b>Cuidado compartilhado: negocia&ccedil;&otilde;es    entre fam&iacute;lias e profissionais em uma creche</b></font></p>      <p>&nbsp;</p>     <p><font face="verdana" size="3"><b>Cuidado compartido: negociaciones entre familias    y profesionales de una guarder&iacute;a</b></font></p>     <p>&nbsp;</p>     <p>&nbsp;</p>     <p><font face="verdana" size="2"><b>Damaris Gomes Maranhão<sup>I</sup>; Cynthia    Andersen Sarti<sup>II</sup></b></font></p>     <p><font face="verdana" size="2"><sup>I</sup>Nurse; PhD in Sciences; professor,    Nursing School, Universidade Santo Amaro. São Paulo, SP. <a href="mailto:damaranhao@uol.com.br">damaranhao@uol.com.br</a>    <br>   <sup>II</sup>Anthropologist; PhD in Social Anthropology; professor, departments    of Preventive Medicine and Social Sciences, Universidade Federal de São Paulo    (Unifesp); academic director, Unifesp, Guarulhos campus. São Paulo, SP. <a href="mailto:csarti@unifesp.br">csarti@unifesp.br</a></font></p>     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">Translated by Carolina Siqueira Muniz Ventura    <br>   Translation from <a href="http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-32832007000200006&lng=en&nrm=iso&tlng=pt" target="_blank"><b>Interface    - Comunicação, Saúde, Educação</b>, Botucatu, v.11, n.22, p. 257-270, May/Aug.    2007</a>.</font></p>     <p>&nbsp;</p>     <p>&nbsp;</p> <hr noshade size="1">     <p><font face="verdana" size="2"><b>ABSTRACT</b></font></p>     <p><font face="verdana" size="2">Based on a case study of a qualitative nature,    this text analyzes the relationship between families and professionals in a    child day care center in the process of sharing care during early childhood,    using the techniques of observation, interviews and document analysis. The research    studied the families and the professionals of a government-run day care center    in the city of São Paulo. The conflicts between these social actors became evident,    mainly, with regard to care related to feeding and hygiene. The task of sharing    care demands from these professionals not only technical preparation, but training    in listening to children and their families while taking their uniqueness into    account, a requirement that can lead to reflections on the type of care that    is most appropriate for the specificity of the group in question, considering    the characteristics of locality in its historical and social context.</font></p>     <p><font face="verdana" size="2"><b>Keywords:</b> Child rearing. Child day care    centers. Child care. Pediatric nursing. Family.</font></p> <hr noshade size="1">     <p><font face="verdana" size="2"><b>RESUMO</b></font></p>     <p><font face="verdana" size="2">Com base em um estudo de caso, de natureza qualitativa,    analisa-se a rela&ccedil;&atilde;o entre fam&iacute;lia e profissionais de creche    no processo de compartilhar cuidados na primeira inf&acirc;ncia, utilizando    t&eacute;cnicas de observa&ccedil;&atilde;o, entrevistas e an&aacute;lise de    documentos. Os sujeitos da pesquisa foram os familiares e os profissionais de    uma creche p&uacute;blica na cidade de S&atilde;o Paulo. Os conflitos entre    esses atores sociais evidenciam-se, sobretudo, nos cuidados com a alimenta&ccedil;&atilde;o    e a higiene. Al&eacute;m do preparo t&eacute;cnico, a tarefa de compartilhar    cuidados demanda, dos profissionais a forma&ccedil;&atilde;o no sentido da disposi&ccedil;&atilde;o    para escutar as crian&ccedil;as e suas fam&iacute;lias em sua alteridade, exig&ecirc;ncia    esta que abre a possibilidade de um espa&ccedil;o de reflex&atilde;o sobre o    cuidado mais adequado para a especificidade do grupo em quest&atilde;o, considerando    as caracter&iacute;sticas da localidade, em seu contexto hist&oacute;rico e    social.</font></p>     <p><font face="verdana" size="2"><b>Palavras-chave:</b> Educa&ccedil;&atilde;o    infantil. Creches. Cuidado da crian&ccedil;a. Enfermagem Pedi&aacute;trica.    Fam&iacute;lia.</font></p>  <hr noshade size="1">     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2"><b>RESUMEN</b></font></p>     <p><font face="verdana" size="2">Basado en un estudio de caso, de naturaleza cualitativa,    este texto busca analizar la relaci&oacute;n entre familia y profesionales de    una guarder&iacute;a en el proceso de compartir cuidados en la primera infancia,    utilizando t&eacute;cnicas de observaci&oacute;n, entrevistas y an&aacute;lisis    de documentos. Los sujetos de la investigaci&oacute;n fueron las familias y    los profesionales de una guarder&iacute;a en la ciudad de S&atilde;o Paulo.    Los conflictos entre estos agentes sociales se evidencian, sobre todo, en los    cuidados con la alimentaci&oacute;n y la higiene. Adem&aacute;s de preparaci&oacute;n    t&eacute;cnica, la tarea de compartir cuidados exige de los profesionales la    capacitaci&oacute;n en el sentido de la disposici&oacute;n para escuchar a los    ni&ntilde;os y sus familias en su alteridad. Esta exigencia abre, entonces,    la posibilidad de un espacio de reflexi&oacute;n sobre el cuidado adecuado a    la especificidad del grupo en cuesti&oacute;n, considerando las caracter&iacute;sticas    locales, en su contexto hist&oacute;rico y social.</font></p>     <p><font face="verdana" size="2"><b>Palabras clave:</b> Educaci&oacute;n en la    primera infancia. Guarder&iacute;a. Cuidado del nino. Enfermer&iacute;a Pedi&aacute;trica.    Familia.</font></p>  <hr noshade size="1">     <p>&nbsp;</p>     <p>&nbsp;</p>     <p><font face="verdana" size="3"><b>Introduction</b></font></p>     <p><font face="verdana" size="2">Child care provided on a daily basis is the foundation    of the child's health promotion and includes activities that also integrate    child rearing: sheltering, feeding, cleaning, comforting, protecting, consoling    and providing a playing environment and interactions that encompass situations    in which the children learn about themselves, the other and the culture in which    they are inserted. Child care implies constant interaction between adults and    children, during the teaching and learning process of social rules and cultural    practices related to satisfying basic human needs. Thus, child care is the link    that integrates child rearing and health (Maranhão, 2000 a).</font></p>     <p><font face="verdana" size="2">Providing child care means understanding the    child's singularity as a being that is undergoing a continuous process of growth    and development. It also means helping and teaching the child to identify and    satisfy its needs in each phase and situation, so that the child is able to    constitute its identity, to gradually acquire autonomy, and to socialize (Veríssimo,    2003; Maranhão, 2000 a).</font></p>     <p><font face="verdana" size="2">In the human species, the newborn's dependence,    together with its capacity to express its basic needs through cries, facial    mimicry and other body movements, awakens in the adult emotions and caring attitudes.    At the same time, it enables the necessary interaction between the newborn and    the caregiver, humanizing it.</font></p>     <p><font face="verdana" size="2">In this process, the child gradually constitutes    itself as a person separated from the mother and defines its similarities and    differences in relation to its environment. The expressions and gestures of    the person who takes care of the child and interacts with it are its first mirror.    The reactions of the mother or of another caregiver to the child's body or manifestations    inform it about who the child is and about the cultural environment where it    lives (Wallon, 1995).</font></p>     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">The construction of body awareness – the image    of the representations that the child learns with the other – is shaped by life's    concrete conditions, by language, customs, beliefs and by the knowledge of each    period of time. This "notion of one's own body", in turn, will be permanently    integrated into the development of personality before the other, defining the    child's relationships to the environment (Wallon, 1995).</font></p>     <p><font face="verdana" size="2">Throughout the times, human groups have developed    relationships, knowledge and technologies with the purpose of taking care of    and educating their younger members, as well as maintaining the health of individuals    and of the group.</font></p>     <p><font face="verdana" size="2">The social changes that derive, among other aspects,    from birth planning and from the insertion of women in the labor market have    resulted in the organization of other forms of providing and sharing child care    on a daily basis. One of them is the increasing search for a child day care    center, an institution that was created to assist low income families, but that    has gradually become a specialized space for child rearing and care.</font></p>     <p><font face="verdana" size="2">The family must choose the day care center where    the child will receive, in a complementary way, education and care. Frequently,    the impossibility of meeting the demand in government-run day care centers or    the high cost of private day care centers do not allow families to choose based    on their principles, values and criteria. This impossibility may determine an    <i>asymmetric relation</i> between users and the institution, according to Sarti    (1998). </font></p>     <p><font face="verdana" size="2">Conflicts between professionals and the family    regarding child rearing and care may affect the child not only from the standpoint    of its process of learning and global development, but also from that of its    health (Maranhão, 2005).</font></p>     <p><font face="verdana" size="2">Obviously, body care is part of health care;    however, beyond the criteria mentioned by biomedicine, body perception and its    classification as "normal", "pathological" or "deficient", "clean" or "dirty",    are guided by cultural meanings that correspond to the worldview and social    organization of the group to which the individual belongs (Douglas, 1966). Thus,    health and illness are hybrid phenomena, for they articulate biological, psychic    and socio-cultural dimensions, as has been extensively pointed out by the literature    (Sarti, 2001; Canguillem, 2000; Maranhão, 2000 b; Berlinguer, 1998; Ferreira,    1994; Helman, 1994; Douglas, 1966).</font></p>     <p><font face="verdana" size="2">Families have perceptions and evaluations regarding    children's health problems that are based on their own explanatory models of    illnesses and their treatments (Loyola, 1984). A health practice that originated    and is valued in the family environment may be considered inadequate in the    day care center. This mismatch constitutes the central axis around which conflicts    develop in the relationship between families and day care center professionals,    as each one of them will try to affirm his or her own point of view.</font></p>     <p><font face="verdana" size="2">Adhesion to the institution's values, considered    positive in the professionals' perspective, may not be so in the family's opinion.    To the family and, consequently, to the child, it may bring confrontation with    their values and customs, something hard to cope with. </font></p>     <p><font face="verdana" size="2">Some families may resist, even though non-deliberately,    and maintain their practices in an attempt to preserve their social and cultural    identity. This procedure can be analyzed in two different ways: as a problem    related to class subordination, since professionals and services' users may    belong to different economic strata (Boltanski, 1984), and through differences    in values, beliefs and knowledge regarding what good child care is. Here, we    try to situate this discussion both in the social and cultural planes.</font></p>     <p><font face="verdana" size="2">The aim of this work, based on a case study,    was to analyze the relationship between families of children assisted by a day    care center and the institution's professionals, in the process of sharing child    care in early childhood. This relationship, which is asymmetric, is pervaded    by mutual expectations whose intensity enables the emergence of conflicts, tensions    and possibilities that must be constantly dealt with, in order to promote joint    actions of child care.</font></p>     ]]></body>
<body><![CDATA[<p>&nbsp;</p>     <p><font face="verdana" size="3"><b>Methodology</b></font></p>     <p><font face="verdana" size="2">Given the study's object – the analysis of relationships    in a day care center -, the qualitative methodology was used, more specifically,    the case study method (Becker, 1999). Ethnographic techniques of data collection    were utilized: analysis of the basic guidelines contained in the institution's    documents, participant observation of the day care center's daily routine, and    open interviews (based on a script) with ten professionals, thirteen relatives    (father or mother) and eight children.</font></p>     <p><font face="verdana" size="2">Fieldwork was developed between November 2001    and January 2003, at a government-run day care center located in the south region    of the city of São Paulo. This region was classified in the fourth position    regarding the Human Development Index (HDI), compared to the city's other regions,    but the major part of the families lives in regions with lower HDI. In order    to situate the place from which the subjects spoke, a "skeleton" of the institution    and its users was constructed, based on quantitative data, constituting what    Malinowski (1980) called "group anatomy". Afterwards, the daily facts that were    observed were analyzed, which, in the language of the same author, are "the    flesh and blood", the expressions and discourse of "the natives" who constitute    the "spirit" of the researched group. The perspectives of the professionals,    families and children were taken into account (Maranhão, 2005).</font></p>     <p><font face="verdana" size="2">The analysis articulated the different discourses    collected in the interviews and data from the participant and documental observations,    aiming to apprehend the point of view of the investigated subjects concerning    the family-professional relationship in the process of sharing child care. Based    on data triangulation, four thematic axes of analysis were outlined: the construction    of a partnership between the family and the day care center; the care that is    shared between them and the child; the relationship between the day care center    and the family, seen in the child's perspective; and, finally, the necessary    complementariness between the day care center and the family for the child's    adequate care.</font></p>     <p><font face="verdana" size="2">This article presents results referring to the    second theme. Feeding and hygiene were focused, as they constitute significant    axes around which conflicts between families and professionals were revealed,    causing the need of permanent negotiations.</font></p>     <p><font face="verdana" size="2">The research project was approved by Unifesp's    Committee for Ethics in Research (process no. 0177/02), complying with all the    requirements of Law 196/1996 of the Ministry of Health, which regulates research    involving human beings. The consent was given by the interviewed adults and    by the children's mother or father. Names are fictitious to ensure secrecy.</font></p>     <p>&nbsp;</p>     <p><font face="verdana" size="3"><b>Results and discussion</b></font></p>     <p><font face="verdana" size="2"><b>Feeding:</b> I was gradually changing, and    they were too...</font></p>     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">One aspect of care that worries both mothers    and child educators is the transition of food habits from the domestic scope    to the day care center, mainly when the child rejects the food offered in the    institution. This is interpreted as a form of child language that expresses    some level of refusal. Many authors state that when the child refuses the food,    this may trigger in the mother, or in another person who plays the maternal    role, a feeling of guilt and rejection of her care, as was observed in the behavior    and discourse of the subjects in this study (Ferreira, 2006; Nakano, 2003; Brazelton,    1990). </font></p>     <p><font face="verdana" size="2">Feeding, like any body occurrence, involves biological    aspects related to organic survival, highly intertwined with psychism and cultural    practices. To the human baby, oral experiences that take place in the act of    feeding are the first link with the environment (Vygotsky &amp; Luria, 1996).</font></p>     <p><font face="verdana" size="2">In the baby's development process, the food that    comes through its mouth and satiates its hunger informs it about what is internal    and external, helping it construct, gradually, the perception that it has a    body separated from its mother. This process will be the basis of its identity    (Wallon, 1995). Providing food is the first maternal role. During pregnancy,    this happens through the physiological symbiosis between the fetus and its mother    and, after birth, through breast-feeding, a role that is full of affectivity    (Ferreira, 2006; Nakano, 2003; Brazelton, 1990). Due to this, sharing this role    is a challenge to mothers, who conceive it as theirs par excellence, a role    that constitutes their identity. It is challenging also to educators, mainly    when they take care of newborns that are being exclusively breastfed. They have    to console the babies between breastfeeding sessions, while the mother has not    arrived yet or when she leaves.</font></p>     <blockquote>       <p><font face="verdana" size="2">(...) when she was admitted, she only had milk      from my breast. And here she used to drink milk from a small glass, never      from the milk bottle. Then, later, she started to eat a kind of porridge that      they gave to her, and everything was going fine. I was gradually changing,      and they were too... (Mother of one and a half-year-old Licia)</font></p> </blockquote>     <p><font face="verdana" size="2">Many deals are made by mothers and educators:    the type of food, the way of offering it, the menu that gradually changes according    to the child's growth and increasing independence. Thus, not only objective    information is shared, but also subjective information. In the weaning process,    generally associated with the baby's admittance to the day care center, the    mother may feel "lost" when she realizes that her child can survive without    her. The mother's experience of loss is one of the dimensions that must be dealt    with in the child's adaptation to the day care center.</font></p>     <blockquote>       <p><font face="verdana" size="2">I was very insecure. I used to come to breast-feed      her at noon and I saw that she was calm. But, afterwards, they said that when      she saw me, she cried more. So, after the second week, I didn't come anymore.      Oh, it's horrible, isn't it? Because during eight months, I stayed only with      her, everyday, and all of a sudden we separated. I got lost, I stayed at home      and I didn't know what to do, I kept tidying her things up... (Mother of one      and a half-year-old Licia)</font></p> </blockquote>     <p><font face="verdana" size="2">Licia came to the day care center at the age    of eight months, an age in which she could already be receiving other types    of food, complemented by her mother's milk in the morning and at night. Thus,    the educators "negotiated" with her mother the substitution of the midday breast-feeding    session for lunch. It was "negotiation", because the offer of any food to the    child, by the mother, has an affective meaning.</font></p>     <blockquote>       ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">I stay here to make her eat because I think      she won't eat. After she does, I leave. She still cries everyday. I go in,      drink coffee with her, stay there keeping her company, then I go to the room      and play for a while. She realizes I'm leaving and starts to cry, and then      I have to hand her over to one of the educators and leave. (Mother of one      and a half-year-old Licia)</font></p> </blockquote>     <p><font face="verdana" size="2">After some time, the mother notices that collective    conviviality has advantages in terms of a broader food repertoire. In addition,    the child learns to help itself and taste food that, at home, was either not    offered or not accepted. Sometimes, the child eats food at the day care center    and does not accept it at home, some mothers say. The child behaves in a different    way because it realizes that the home and the day care center are distinct places    and in each one there are people with different social roles.</font></p>     <blockquote>       <p><font face="verdana" size="2">And now she eats, I didn't know it, but she      loves vegetables. I didn't think so, because children usually don't like vegetables,      but she loves them. Now, we try to give her more vegetables. She eats better      when she is with other children, because she doesn't like to eat alone. I      guess she eats well here. (Mother of one and a half-year-old Licia)</font></p> </blockquote>     <p><font face="verdana" size="2">In the perspective of the interviewed children    – between five and six years of age – who have been attending the day care center    for a longer period of time, experiences at home and at the day care center    are important references. The experienced situations are classified as good    or bad, according to what each place provides of pleasure or annoyance. </font></p>     <blockquote>       <p><font face="verdana" size="2">I prefer having lunch at my home, because when      we can't take anymore, when we don't want to eat any more food, we don't.      At the day care center, we have to eat everything; the teacher says we must      grow strong. But I didn't want to stay only at home because my grandpa gives      me a big plate full of food! (Karen, six years old)</font></p> </blockquote>     <p><font face="verdana" size="2">When the food scheme at home is very different    from that of the day care center, a transition period is necessary, during which    the child's habits and customs are maintained, and the child gradually adapts    to the new menu.</font></p>     <blockquote>       <p><font face="verdana" size="2">Marcos is two years old and was admitted to      the day care center this year. His mother wanted us to give him the milk bottle      in every meal, because, according to her, he didn't accept other types of      food. She used to bring the milk and the thickener. One day, he accepted to      have lunch and I asked the girls to give the milk back. The mother was very      angry because we hadn't given him the milk bottle at lunchtime. My God, she      hit the roof, she arrived here very nervous, swearing at everybody. How could      we let her son starve, and so on. "No, look – I said -, he's eating bread,      drinking milk, there's no need to give him the milk bottle. He doesn't use      the milk bottle anymore". I showed her that it wasn't necessary, because he      was eating well. "When he gets home, you give him the milk bottle. But there's      no need to do it here, he eats food." In this way, you don't do what she wants,      but you don't make her feel sad, either. In fact, I think that, to the mother,      the milk bottle has a meaning: I'm not there, but if the milk bottle is, it      is in my place. (Nursing Technician)</font></p> </blockquote>     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">This nursing technician understood the meaning    that the milk bottle has to this mother. She helped her realize that her son    is not a baby anymore and can eat food that is more suitable to his age, with    autonomy, trying not to make the mother feel sad.</font></p>     <p><font face="verdana" size="2">When the initial difficulties are overcome, the    families praise the day care center for the food, the menu's diversity and the    hygiene in preparing the meals. It is not only the recognition of nutritional    aspects that is at stake, but also the educational and emotional aspects.</font></p>     <blockquote>       <p><font face="verdana" size="2">Another thing they love that we find interesting      is the food. Today, Wilson eats everything, because he learned to eat here.      (Father of six-year-old Wilson).</font></p> </blockquote>     <p><font face="verdana" size="2">Associated with affection, the ways of feeding    the child are constructed in culture and are influenced by the type of food    available in each region, by customs and values, including religious ones. The    day care center professionals accept food restrictions when they are prescribed    by doctors. This not always occurs when they are determined by family customs.    One mother converted to the Hare Krishna religion and requested that they did    not give meat to her daughter, but they did not accept her request: they argued    that, in the collective context, it was hard to prevent the child from eating    the meat offered in the menu – which reveals the professionals' difficulties    in taking into account the users' singularities and values.</font></p>     <blockquote>       <p><font face="verdana" size="2">All the children will eat what there is to      eat, if they want to. We won't let them itch for meat because the mother doesn't      want them to eat it. At her home she won't give them meat, but here we have      it and the child will eat it. (Nursery educator) </font></p> </blockquote>     <p><font face="verdana" size="2">Another family, which was Adventist, requested    that the child did not eat pork. As this type of food was not part of the day    care center's menu, her request was accepted. </font></p>     <blockquote>       <p><font face="verdana" size="2">When we arrived here, we didn't force anything,      but we made two requests: "Look, we'd like that every activity on Saturdays,      and anything with pork was not given to Juliana, because we're educating her      in this principle, and we try to be coherent. (Father of two-year-old Juliana).</font></p> </blockquote>     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">From the child's point of view, the day care    center offers opportunities of access to values, food habits, care and knowledge    that can be different from those of the families, providing other opportunities    for development (Wallon, 1995). In the family, with its own values, beliefs    and habits, the child has a structural place of identity that will accompany    her permanently. Thus, her development process involves dealing with all these    references, and with the implied conflicts and gains (Sarti, 2004).</font></p>     <p><font face="verdana" size="2"><b>Hygiene:</b> I think it is more related to    care...</font></p>     <p><font face="verdana" size="2">In etymological terms, <i>hygiene</i> derives    from the Greek word <i>hygeinos: what is healthy</i>. However, common sense    has attributed to it a more restricted meaning: neatness and cleanliness. The    dictionaries of the Portuguese language identify this double meaning: a science    that aims at health preservation, illness prevention and at cleanliness (Maranhão    &amp; Vico, 2004; Vigarello, 1996). In the 17<sup>th</sup> century, the term    "clean" begins to acquire moral connotations and starts to mean, also, distinction,    elegance, order (Rodrigues, 1999; Vigarello, 1996).</font></p>     <blockquote>       <p><font face="verdana" size="2">Since the end of the 18<sup>th</sup> century,      the healthy, clean, valid body, the purified, limpid, ventilated spaces, the      medically perfect distribution of individuals, places, beds, utensils, the      interplay between 'care' and 'careful', have constituted some moral laws that      are essential to the family. (Foucault, 1979, p.199)</font></p> </blockquote>     <p><font face="verdana" size="2">Hygiene rules are cultural constructions and,    as such, they reveal more the human need to order form and function, to put    something that seems chaotic in order, than a technique based on the knowledge    of diseases transmission or causes (Douglas, 1966).</font></p>     <p><font face="verdana" size="2">The day care center professionals use it as synonymous    with cleanliness. They refer to conflicts caused by the children's untidiness,    which is frequently attributed to the mother's lack of attention and poverty.</font></p>     <blockquote>       <p><font face="verdana" size="2">Sometimes, the mother cut a piece of the sheet,      transformed it in a diaper and brought the little girl here wearing that.      Sometimes, she didn't have a cloth, anything, and the child arrived here wearing      panties, holding poo. We tried to advise her in the best way we could, but      it is very difficult to advise this kind of mother. They went to visit her      at her house, and beside the washboard there was a pile of clothes. They had      been there for more than two weeks and the pile was growing. I don't know      what she did with those clothes, I don't know if she washed them or not. We      had to bathe the child everyday and dress her with clothes from the day care      center, because her clothes smelled badly. She was a beautiful child, but      she was not well cared for. I used to be shocked and tried to advise the mother:      "Let's do things in this way...". (Pedagogical Coordinator)</font></p> </blockquote>     <p><font face="verdana" size="2">Taking care of children with different social    conditions implies dealing with diverse customs. Also, it implies recognizing    the day care center's limitations before the families' economic and cultural    problems, associated with precarious dwellings and difficult access to health    services and goods that are essential to the children's wellbeing. Besides the    limitations imposed by poverty on families and educators, each family reacts    to and copes in its own way with its life conditions. When the educators deal    with these differences, even though they recognize that the lack of conditions    at home may hamper child care, this does not prevent them from giving moral    connotations to the fact, and child care becomes one of the axes used to judge    the family in moral terms.</font></p>     ]]></body>
<body><![CDATA[<blockquote>       <p><font face="verdana" size="2">The mother was careless, she knew that, when      the girl arrived here, she would be bathed and we would dress her in clean      clothes. We asked her to return the clothes, but she never did. She got more      and more careless because she saw that the day care center helped a lot, right?      The mother reached a point... It seems they were facing serious economic difficulties,      she had no husband, she was always with a new husband. We thought she was      prostituting herself. People commented, we can't judge a person by her clothes,      but sometimes the weather was very cold and the mother arrived here wearing      shorts and a top, you know, she was always wearing strange clothes, and people      commented that they saw her at the Alleyway (a street near the day care center      with prostitution houses and hotels) talking to men, you know? We heard the      mothers commenting on it. (Kindergarten educator) </font></p> </blockquote>     <p><font face="verdana" size="2">The families are evaluated by the educators according    to the children's appearance and also to the way in which they behave and present    themselves at the day care center. Although they try to understand the difficulties    faced by the poorer families, they compare and praise those that, despite being    poor, are <i>clean and careful</i>.</font></p>     <blockquote>       <p><font face="verdana" size="2">I got to know many kinds of families. There      were mothers who didn't care much about the child, who didn't care about the      child's clothes. Other families, despite being very poor, cared too much for      the child. We interviewed the mothers to investigate how her hygiene with      the child was at home. There was a family that lived in a slum, with a washboard      for collective use, but they had hygiene notions and washed the clothes inside      a bucket, so as not to mix their clothes with the others'. It was a model!      (Babies' Caregiver)</font></p> </blockquote>     <p><font face="verdana" size="2">Thus, by observing the child's body, the educators    evaluate and criticize the families they think are negligent. However, they    take good care so that the researcher will not think they have prejudiced opinions.    This derives from the current tendency, in child education, of revising the    view about poor families as "needy", "incapable", "unstructured", "negligent".</font></p>     <blockquote>       <p><font face="verdana" size="2">I think it is more related to care. I don't      like to talk like this because it seems we have prejudice – and I don't –      I try to be humble in my daily work, I try to reach the... (family?) level.      We are all equal, but some mothers are not hygienic with her kids. They don't      separate the clothes that the child peed on, everything gets mixed in the      backpack and starts to smell bad, and then they don't wash the backpack! (Kindergarten      Educator) </font></p> </blockquote>     <p><font face="verdana" size="2">The professionals are aware that hygiene standards    may be different in different contexts. However, at the same time, they deny    the prejudice and make associations that reaffirm it.</font></p>     <blockquote>       ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">I am from Curitiba and there we try to follow      some hygiene standards, taking care not to promote contamination. At home,      we know it is never like this, even at our own home, we have our lapses, right?      As we assist families with different incomes, we see that, generally speaking,      those with lower purchasing power show lack of hygiene. For example, Edilson's      mother improved a lot the children's hygiene, but not her own. Oh, poor thing,      it is because she is married to an old man, right? (Nursing Technician)</font></p> </blockquote>     <p><font face="verdana" size="2">The association the professionals make between    the family's carelessness, particularly hygiene, with the children's episodes    of illness changes the focus of the day care center's planning. The employment    of standard precautions, instead of the adoption of measures relating only to    the ill child, would avoid stigmas experienced by the children (Maranhão &amp;    Vico, 2004; Maranhão, 2005).</font></p>     <blockquote>       <p><font face="verdana" size="2">Sometimes, we drink juice in the glass and      the teacher sticks Sellotape on it. Then, we have to remember it, otherwise      we spread diseases to our colleagues. It is not everybody that will have Sellotape      stuck to the glass. Only that person who is sick... The boys laugh, but the      girls don't. (Karen, six years old)</font></p> </blockquote>     <p><font face="verdana" size="2">Body care also includes esthetics, ornaments    and accessories used by the families to "protect" the child, to thank for divine    favors, expressing their beliefs and values. The educators may find these strange,    which reveals a mismatch between professionals and families, a source of disagreements    that leads, once again, to negotiations:</font></p>     <blockquote>       <p><font face="verdana" size="2">Some mothers make promises: "After my son's      first birthday, I'll cut his hair and take it to Aparecida do Norte". But      the thing is, his hair was this long and full of lice. One day, the educator      cut the boy's hair without talking to the mother. She was trying to help:      "I think I'll cut this boy's hair, the mother probably doesn't have money      to have it cut". Then, the mother came here and made a scene. She wanted the      boy's hair because, after his first birthday, she would take it to Aparecida      do Norte. And the educator had already thrown the hair in the garbage. Because      we thought we had to keep the child clean, shining, smelling good, his hair      short, because this was our role. The mother, poor thing... We had to search      for the hair in the garbage, so that his mother could take it. And then we      learnt one more lesson: I won't cut anybody's hair anymore! (Pedagogical Coordinator)</font></p> </blockquote>     <p><font face="verdana" size="2">The cultural differences that pervade the process    of sharing care with the families teach the educators about the limits regarding    what they consider "the best for the child". Their judgment of what the best    care is involves religious, esthetic, and gender values, which reveal prejudices    based on different perceptions. By referring to the mother as "poor thing",    they devaluate her perspective. Some families enforce their authority, like    the right to choose what they think is best for their children. Other families,    due to fear of social rejection, end up changing their practice, in view of    the professionals' arguments.</font></p>     <blockquote>       <p><font face="verdana" size="2">Before Leo came to the day care center, I took      him to see a <i>benzedeira<a name="_ftnref2"></a><a href="#_ftn2"><b><sup>1</sup></b></a></i>,      I thought he was weak, small. My neighbor used to say: it is a spell, the      evil eye, right? The <i>benzedeira</i> confirmed: "It is the evil eye." After      three days, the same thing, he was feeling blue, I took him to see the <i>benzedeira</i>      again. "The evil eye affects him very much, I'll do something that will prevent      this from happening." And it worked all right. Then, the day care center asked      me what this was [the amulet]. I said that... I thought: Maybe the day care      center doesn't like it. Then I took it out. I thought that the day care center      didn't like it. Nobody said anything. They asked me, I reckoned the day care      center didn't like it. Then I took it out. I was like... maybe the day care      center doesn't like it. Then I took it out. (...) After three days, I was afraid      he was going to pull it out [the pin]. Then I took it out, he was a little      baby. Then I got scared, after that he pulled it and I took it out. I'm more      afraid that he pierces himself. He had already grown up a little, I was afraid      that he would pull it, pierce himself, and then I took it out. He was just      a little baby, I was afraid. (Mother of three-year-old Leo).</font></p> </blockquote>     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">Our interpretation of this case is that the mother    searched for what she considered to be spiritual protection for her son's body,    which could become weak due to the <i>evil eye</i>. This protection was performed    by an amulet, a red accessory stuck with a pin to the child's clothes. When    she became user of the day care center's services, she realized it corresponded    to a practice that was considered inadequate, implying her son's rejection.    Which was the biggest fear? Of the illness or of the stigma? Or of rejection?    She transformed the protection into culturally accepted forms, such as wrapping    him up, breastfeeding him, watching over his health.</font></p>     <blockquote>       <p><font face="verdana" size="2">Everything she couldn't do during the day,      she wanted to do before leaving: changing his clothes, putting five sweaters      on him, four pairs of trousers, breastfeeding! She thought he was not putting      on weight, because he was always ill. She wanted to know if he was all right,      if he had a fever, until she realized he could be fine at the day care center.      It took her a long time. I mean, she was very kind to everybody, but she was      so insecure! She agreed with everything you said, but you noticed she was      scared, desperate: "Why was he sick? Does he have a fever again?" She called      from her work to know if he had a fever, what he had eaten. It was just like      that (...) You are right there and then she goes to the educator and confirms      what you had just said. And by confirming things, she gradually created a      bond with the team. Not just with the nurses. Then she realized that you were      really participating in what was happening to her son. (Nursing Technician)</font></p> </blockquote>     <p><font face="verdana" size="2">Two dimensions underlie the conflicts that occur    in the process of sharing care related to feeding: one concerns the affectivity    that is implicit in the act of feeding, which requires sensitivity to identify    the meaning of this act to the family, helping them to understand that the construction    of autonomy by the child is related to the development of the child's capacity    to provide its own food. The other dimension refers to cultural, regional or    religious differences. If they cannot be accepted and gradually incorporated,    they must, at least, be recognized.</font></p>     <p><font face="verdana" size="2">In the conflicts involving hygiene care, the    disciplinary posture of the professional team can be clearly noticed, associated    with customs moralization. However, there are evident cases of negligence that    go against children's rights and require that some work is carried out with    the family, so as to reflect, with it, on the meaning of care in the process    of identity construction. Dealing with the adult's negligence towards the child,    classified as ill-treatment, is a complex, subtle and delicate task, for it    regards looking at the other. It can reveal several kinds of prejudices. What    is seen as "negligence" can express a different form of care.</font></p>     <p>&nbsp;</p>     <p><font face="verdana" size="3"><b>Final remarks</b></font></p>     <p><font face="verdana" size="2">Conflicts are inherent in the relationships between    professionals and relatives of children who attend day care centers. They become    evident in the process of sharing care, mainly related to feeding and hygiene.</font></p>     <p><font face="verdana" size="2">Sharing child care requires that the professionals    are prepared and willing to listen to children, parents, grandparents and the    community, recognizing their uniqueness. This should constitute a reflection    forum about what the best care and the best education would be to this specific    group, in its historical, social and cultural context.</font></p>     <p><font face="verdana" size="2">In this task, the conception of parents' participation    is that of co-builders of the child rearing and care project, through a joint    definition of conceptions, norms and rules. This implies a professional attitude,    taking into account the store of accumulated knowledge on child development,    education and care and on standards of what constitutes a good day care center,    as well as knowing them, questioning them, and reflecting on their applicability    to a specific context. It implies, also, in opening the way to "non-scientific"    knowledge that illuminates the family practices, and which also constitutes    knowledge forms.</font></p>     ]]></body>
<body><![CDATA[<p><font face="verdana" size="2">Although this research study focused on the process    of sharing child care in the context of a day care center, it can contribute    to the reflection of professionals who work in family health programs and at    basic health units. These professionals should take into account the complexity    and the dynamics of the relationships that are established around child care.    </font></p>     <p>&nbsp;</p>     <p><font face="verdana" size="3"><b>References</b></font></p>     <!-- ref --><p><font face="verdana" size="2">BECKER, H.S. <b>Métodos e pesquisas em ciências    sociais</b>. 4.ed. São Paulo: Hucitec, 1999.</font><!-- ref --><p><font face="verdana" size="2">BERLINGER, G. <b>A doença</b>. São Paulo: Hucitec,    1998.</font><!-- ref --><p><font face="verdana" size="2">BOLTANSKI, L. <b>As classes sociais e o corpo</b>.    2.ed. Rio de Janeiro: Graal, 1984.</font><!-- ref --><p><font face="verdana" size="2">BRAZELTON, T.B. 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<body><![CDATA[<p><font face="verdana" size="2">Received on 10/07/06.    <br>   Approved on 27/01/07.</font></p>     <p>&nbsp;</p>     <p>&nbsp;</p>     <p><font face="verdana" size="2"><a name="_ftn1"></a><a href="#_ftnref1">*</a> Based    on Maranhão, 2005.    <br>   <a name="_ftn2"></a><a href="#_ftnref2">1</a> A woman who blesses children to protect    them against diseases, the evil eye, etc.</font></p>      ]]></body><back>
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</article>
