Many European countries have high rates of young children in institutions, where the physical care of the child predominates, with social/emotional needs a secondary concern. Institutional care is a very poor substitute for positive family care, increasing the risk of development delay, attachment difficulties, neural growth dysfunction and mental health disorders. This article provides an update on a series of projects that have highlighted this issue in Europe, arguing that babies and small children aged less than 3 years old, with or without disability, should not be placed in residential care without a parent or primary caregiver. This principle has been discussed by the UN General Assembly (2009) and specific guidelines have been produced for all 193 member states.
