The authors also wish to thank Dr Mark Dickson and Dr Fatiha Karam for their critical reading of the manuscript. Footnotes Contributors: CW, WL, GW and YL contributed to the conception

and design, acquisition of selleck the data, analysis and interpretation of the data, and the drafting of the articles. LL, FY, LC and YB were involved in the collection and analysis of the data. All authors approved the final version of the manuscript. Funding: This work was supported by the National Natural Science Foundation of China (Grant no: U1204823 and U1304821), National Key Basic Research Program of China (Grant no: 2012CB526709), High-level Personnel Special Support Project of Zhengzhou University (no: ZDGD13001), China Postdoctoral Science Foundation (Grant no: 20100471003 and 201104401), and Medical Scientific Research Foundation of Health

Department of Henan Province (Grant no: 201004042 and 201204051). Competing interests: None. Ethics approval: Ethics approval was granted by the Zhengzhou University Medical Ethics Committee. Provenance and peer review: Not commissioned; externally peer reviewed. Data sharing statement: No additional data are available.
The foundational UNICEF framework for child health emphasises that childcare practices (CCP) are vitally important in promoting child nutrition and health.1 Sociodemographic factors (eg, parental education and income) are also emphasised in the UNICEF framework, and are consistently found to have a graded relationship with health.2 However, little is known about the degree to which CCP are consistently related to child health in the face of the widely differing sociodemographic backgrounds that characterise societies. Childcare is a complex concept including a range of behaviours and practices of caregivers that provide the food, healthcare, stimulation, and emotional support necessary for children’s healthy survival, growth and development.3 As part of CCP, feeding and healthcare underlie dietary sufficiency and protection from disease, which in turn impacts

child health, for which physical growth is a critical marker.4 A robust finding in public health research is that of a graded relationship between sociodemographic status (SDS) and health.5 Low SDS translates predictably into lessened food security and reduced access to healthcare. However, AV-951 even in households with food insecurity due to poverty and poor access to healthcare, families can optimise the use of the existing resources to promote health.3 6 This calls for further research to illuminate the relationship between childcare and child health in economically vulnerable as well as secure households and communities. An ecological approach to such research calls for specification of proximal influences on child health such as feeding practices, as well as consideration of more distal factors such as caregivers’ health literacy, availability of resources such as clean water and sanitary living conditions and accessible healthcare.