A Partnership Approach

Obesity Prevention in Child Care

Sandra Rhoades, MPH, RD

Director, CACFP Obesity Prevention Unit

NYS Dept. of Health

Diane Craft, PhD

Professor, Physical Activity Department

State University of New York at Cortland

Objectives

Obesity Prevention in Child Care

Describe Early Childhood Obesity Prevention workgroup

Present the proposed standards Nutrition Screen time Breastfeeding Physical activity

Discuss challenges and next steps

Background

NYS Dept. of Health Division of Nutrition

Bureau of CACFP Division of Disease Prevention

Bureau of Chronic Disease Prevention

CDC Division of Nutrition, Physical Activity, and Obesity Develop an Action Guide Provide guidance to States

To implement model policies and environmental strategies Nutrition Physical activity Screen time reduction

Statistics

4,000 child care centers 14,000 family day care

homes 650,000 child care

spaces 14,000 participate in

CACFP 350,000 children served

31.5% of 2-4 year olds

32% of Upstate public school students

40% of NYC public school students

Child Care Data (2010) Obesity Data (2010)

Obesity Prevention in Child Care Partnership – Steering Committee

Dept. of Health CACFP Obesity Prevention

Program Office of Children

and Family Services Child care

licensing and subsidy

NYS Head Start Collaboration

Physical Activity Specialist

NYS Early Care Advisory Council members

Early Care and Learning Council

Partnership Focus

Obesity Preventi

on

Regulations and Policies

Quality Rating System

Education and

Training

Common Standards

Increase physical activity Reduction in screen time Decrease in sedentary behavior Supporting breastfeeding mothers Expansion of required training to include

topics related to obesity prevention, including CACFP’s Healthy Meal Pattern

Support for CACFP Healthy Meal Pattern

Nutrition and Screen Time

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CACFP Obesity Prevention

Healthy Child Meal Pattern 1% or Less for children over 2 years No flavored milk for children under 5 years Juice served no more than once per day (breakfast or

snack) Water served at snack if no other beverage Sweet grains limited to twice per week (breakfast or

snack) EWPH Child Care Settings

Child care centers Day care homes

Breastfeeding Friendly Centers and Homes

NYS Day Care Licensing - Nutrition Existing Standards

Adequate food must be available in appropriate portions for size and age of children

Center programs must have 4 weeks of menus reviewed by nutrition professional (or CACFP)

Medical, religious and personal food preferences must be accommodated

Children must be helped to feed themselves Safe drinking water must be available at all times Every effort must be made to accommodate a

breastfed child

NYS Day Care Licensing - Nutrition Proposed Program Standards

No new nutrition or breastfeeding standards

Proposed Required Training Topics Healthy menu planning Obesity prevention Benefits of and how to encourage

breastfeeding for mothers returning to work

NYS Day Care Licensing – Screen Time

Proposed Program Standards Screen Time

Center: Infants (under 18 mo) must not be exposed to any screen time

Family: TV must be off when not in use for program activities

Must be part of planned, developmentally appropriate program for educational, social, physical or other learning objective

Screen time during meals is prohibited Screen time should not be used solely to occupy

time

Quality Stars NY – Nutrition Standards

Points awarded if: Program compares

revenues and expenses to budget, OR

Fiscal records and budget are reviewed to ensure no deficit OR

If eligible, program participates in CACFP

Meals and snacks served or consumed meet the CACFP meal pattern for ages in care

Program implements an obesity prevention program

Staff attends training on obesity prevention

Program supports breastfeeding

Before Partnership With Partnership

Quality Stars - Screen Time Standards

Only to the extent that credentialing programs address it

Program must have a policy: Regarding use of

TV/Video Birth-2 years: None 2-5 years:30 min/wk Educational only Commercial-free

Before Partnership With Partnership

NYS Early Care and Education Core Body of Knowledge Framework

Proposed changes: Considers developmental appropriateness

of screen time Provides meals that align with NY CACFP

meal patterns Limits fruit juice to 4 oz. per day Encourages exclusive breastfeeding until 6

months and accommodates breastfeeding mothers

Beyond the Partnership

NYS Governor’s Race to the Top Early Care and Learning Recognized CACFP’s impact on early child

care and education

NYS Department of Health Commissioner Agency-wide Childhood Obesity Council Advocating for CACFP as the nutrition

standard in licensing

Physical Activity

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NYS Day Care Licensing – Physical Activity

Proposed Program Standards Daily schedule must include “tummy time” Offer indoor activities, out door activities

and variety of large muscle activities throughout the day

There must be physical activity every day

Proposed Required Training Topics Promoting play and physical activtiy

Quality Stars – Center & Home-based Physical Activity Standards

Daily opportunities to move freely under adult supervision to

Explore indoor and outdoor environment

Including tummy time when awake

15 min. PA/hr in care

Developmentally appropriate PA

Include structured and unstructured PA

Moderate to vigorous PA

Both indoors and outdoors

Infants/Toddlers to 18 month

Children over 18 month

NYS Early Care and Education Core Body of Knowledge Framework

Children must effectively develop small muscle skills and large muscle coordination through play

Provide opportunities for gross motor and outdoor play for the development of large motor skills

Recognize and respect importance of play in children’s development and growth

Provides children with at least 120 min. of gross motor activity (for children attending a full day program) each day through both structured and unstructured play

Existing Policies Proposed Policies

Consider changing term to

Recommend development of

‘fundamental movement skills’

instead of ‘gross motor activity’

Fundamental Movement Skills

Object Control

LocomotorStability

This is NOT Rocket Science

Let’s try a few fun ways to practice

Fundamental Movement

Skills

Partnership Challenges/Lessons There are no quantitative measures in

regulations Monitoring meals of non-participating

programs Monitoring amount of physical activity Access to physical activity training Breastfeeding Friendly recognition for

non-participating programs Support from Early Childhood Advisory

Council Influential people are important for

policy changes

Next Steps

Supporting implementation of regulatory changes and Quality Stars Rating System

Increasing CACFP participation Revisiting EWPHCCS and DCH models Increasing Breastfeeding Friendly Child

Care programs Creating a physical activity training plan Reviewing progress towards standards

Thank You!

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