Navigating competence challenges: early childhood education teachers’ professional development needs in integrated toddler care and education settings in China

China’s Integrated Early Childhood Care and Education (IECCE) services are expanding, and toddler classes may help alleviate enrollment pressures. However, many institutions may lack the capacity to provide high-quality services for children aged 0–3 years. This study investigated the professional competencies of early childhood education (ECE) teachers working with children aged 0–3 years in toddler classes in China. Ethical approval and participant consent were obtained. Using a narrative inquiry approach, we conducted semi-structured interviews with 28 kindergarten teachers. The findings revealed that teachers had limited competence in observing and interpreting children’s behaviors, handling accidental injuries, and dynamically assessing health risks. They also lacked practical experience in caring for children aged 0–3 years and had limited access to mentorship. Existing in-service programs were often overly theoretical and provided little practical guidance on emergency response and responsive caregiving. Despite these challenges, the teachers expressed strong and specific expectations for professional development needs. They urgently desired direct, ongoing support from medical professionals in daily practice and systematic training that integrated medical education and professional certification to better address real-world classroom issues. These findings can help kindergarten administrators support professional development and provide quality caregiving.