Abstract
Grandmothers are influential caregivers for young children, yet their contributions to child development remains understudied. This study characterized trajectories of grandmother caregiving from infancy to two years and examined their associations with child development. Data came from a longitudinal birth cohort study in rural Pakistan (n=959). Grandmother caregiving behaviors were maternally reported at three months, one, and two years postpartum using a 24-hour recall. Child development (cognitive skills, socioemotional development, and mental health) outcomes were assessed at six years. We found four distinct grandmother caregiving trajectories during infancy: (1) Low (34.9%), (2) Unstable Medium (9.3%), (3) Stable Medium (40.8%), and (4) High (14.9%). Early life grandmother caregiving trajectories longitudinally predicted specific developmental domains in middle childhood. Children with grandmothers in the High trajectory group had higher inhibitory control, and children with grandmothers in the Unstable Medium group had greater socioemotional problems. No meaningful differences with verbal comprehension, working memory, or anxiety scores were observed. Future research should characterize key family members' caregiving patterns throughout childhood to capture the dynamic nature of caregiving. In addition to parents, interventions that engage grandmothers may help create a cohesive caregiving environment and improve child development.