Build Healthy Habits in Child Care and at Home
Vivian Muzyk used to think tales of children refusing to eat vegetables were widely exaggerated. Then she watched her son gag at the taste of anything green — from steamed spinach to pureed peas, she says.
As the communications and marketing coordinator for The North Carolina Partnership for Children, Muzyk knows how important it is for young children to eat nutritious meals and get plenty of exercise. "Making sure my 13-month-old eats a healthy diet is a daily concern," she says.
With almost a third of children ages 2 to 4 overweight or obese in North Carolina, the importance of taking steps early on to promote healthy lifestyles is getting statewide attention with proposed changes for child care centers.
"The North Carolina Child Care Commission is in the process of making some new rules for child care centers related to outdoor play and screen time," says Christina McWilliams, a researcher at the Center for Health Promotion and Disease Prevention at UNC-Chapel Hill. "This shows North Carolina is aware [of the problem] and attempting to make strides. ... Not a lot of states have guidelines. A select few are seeing the importance, and North Carolina is one of those making policy changes."
McWilliams is the lead author of an article in the December 2009 journal Pediatrics that outlined the best-practice guidelines for physical activity in child care. The article includes results about physical activity in child care centers in North Carolina. One finding was that only 13.7 percent of the 96 child care centers studied offer 120 minutes of active playtime during the day, the recommended amount in the Nutrition and Physical Activity Self-assessment for Child Care (NAP SACC) best practices.
The research team developed the list of best practice guidelines for physical activity in child care, drawing on recommendations from major child-oriented organizations, including the American Academy of Pediatrics, the National Association of the Education of Young Children, Head Start and National Association for Sport and Physical Education.
The N.C. Child Care Commission's proposed rule changes include that children age 2 and older have blocks of active playtime with at least one hour of outdoor time throughout the day if weather conditions permit. Centers that operate half time would need to allow 30 minutes of outdoor playtime.
A limit on screen time, including television, videos, video games and computer use, also is part of the new proposed child care rules, with screen time used only to meet a developmental goal and as a free-choice activity. It would be limited to not more than two and a half hours per week per child, other than for special events. These rule changes will be considered in March.
Encouraging physical activity at your child's center
McWilliams says one of the key steps parents can take is to ask the center director about active playtime. "Find out what opportunities are available to children and ask how long children go outside," she says. Young children also shouldn't sit for more than 30 minutes at a time.
Parents can ask whether a center has a written policy on physical activity. McWilliams points out that there are online resources for child care providers that parents can refer staff to such as www.headstartbodystart.org and the 5-2-1-Almost None information at www.nemours.org/service/preventive/nhps/521an.html, which includes tips for parents, too.
To help child care centers provide active play, parents need to send children dressed appropriately to go outside, including shoes with closed toes and backs and coats, hats and gloves in the winter, McWilliams stresses.
What parents can do at home
When children aren't in child care, parents can help keep kids active by providing outdoor time at home and joining in or encouraging their activity with positive feedback. "Also create family activities around something active for the whole family," she advises.
Muzyk, with The North Carolina Partnership for Children, provides additional NAP SACC strategies parents can use at home or share with their child care provider to help children get started on a healthy lifestyle:
*Eat healthy meals and snacks with children. Serve family-style meals where children take a small amount and only take more if they are hungry. This encourages children to pay attention to hunger cues. Food should not be used as a reward or punishment for behavior.
*Switch to low-fat milk when children turn 2. Avoid sugary drinks and limit 100 percent fruit juice to not more than twice a week or less.
*Celebrate special occasions with festive foods that are healthy and treats that aren't food.
*Play with children to encourage active play for at least 120 minutes a day and never withhold playtime as punishment. Active play should be fun and creative with lots of movements, such as follow the leader, dancing, hokey pokey or Simon Says.
*Have children play outside for at least 60 minutes each day, even if it is raining or snowing.
*Limit screen time to two hours a day or less. Children younger than 2 should not watch TV.
The North Carolina Partnership for Children, the organization that leads Smart Start, helps fund the NAP SACC program with help from the state, local Smart Start partnerships, Blue Cross Blue Shield of North Carolina Foundation and the Apple Gold Group. NAP SACC enables child care providers to evaluate their nutrition and physical activities policies and get one-on-one help to improve nutrition and exercise plans.