Early Care and Education (ECE)

Why is This Setting Important?

Most young children spend time in care outside of their home. About 12.5 million children1 birth through age 5 who are not yet in kindergarten are in a nonparental care arrangement at least once a week. That’s 3 in 5 children in this age group.

The number of children in Early Care and Education (ECE) settings makes it one of the best places to help young children build a foundation for healthy living. High-quality ECE programming can have a positive impact on a child’s social-emotional wellbeing, educational achievement, health, and socioeconomic outcomes later in life.

ECE practices and programs can support healthy eating and physical activity when children are young and perhaps for a lifetime. These efforts also play a role in preventing obesity.

What Can be Done?

State ECE systems can adopt standards to:

  • Improve nutrition.
  • Increase physical activity.
  • Limit screen time.
  • Support breastfeeding parents.

With the information on these pages, public health practitioners, ECE advocates, and policymakers can learn about the importance of the ECE setting in preventing childhood obesity, review CDC’s State Licensing Scorecards and find numerous ECE resources.

For potential activities, resources, and examples of what others are doing, see Priority Obesity Strategy: Early Care and Education (ECE) Policies and Activities.

ECE’s Spectrum of Opportunities

The Spectrum of Opportunity Framework

The Spectrum of Opportunities [PDF-665KB] for Obesity Prevention in Early Care and Education Settings guides states to help ECE facilities meet national obesity prevention standards. The framework identifies how states can embed obesity prevention standards into their systems.

The Quick Start Action Guide [PDF-549KB] leads users through the Spectrum and provides action steps to plan or strengthen state-level efforts in obesity prevention.

How can state licensing regulations support best practices for obesity prevention in ECE settings?

In all 50 states and the District of Columbia, ECE programs such as centers, large family care homes, and small family care homes, must follow certain regulations to legally operate. State-mandated licensing requirements can ensure that all ECE programs follow health and safety rules. Licensing regulations, such as high-impact obesity prevention standards, can also encourage widespread adoption of science-based practices that promote healthy eating and physical activity. States typically open their licensing regulations for updates about every 3 to 5 years.

High-impact obesity prevention standards

  • CDC promotes 47 high-impact obesity prevention standards for ECE.
  • These science-based standards are promoted by leading child health organizations for the prevention of childhood obesity in childcare programs.
  • States can include standards in ECE licensing regulations to support the development of healthy habits in young children.

What does the ECE Licensing scorecard provide?

CDC’s State Licensing Scorecards offer one way for public health practitioners, ECE advocates, and parents to understand how well their state’s child care licensing regulations support science-based, healthy eating and physical activity standards

Find information about CDC’s funded programs that include obesity prevention efforts for the ECE setting.

More Information

Find tools, resources and success stories to help states, ECE systems, and public health practitioners promote good nutrition and physical activity in the ECE setting.

Find more early childhood resources from CDC including free training courses and educational materials.


  1. Cui, J., and Natzke, L. Early Childhood Program Participation: 2019 [PDF-1.61MB] (NCES 2020-075REV), National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education. Washington, DC.; 2021.
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The Obesity Prevention in ECE Listserv and News Blasts share expertise and resources around improved nutrition, physical activity, and obesity prevention in the ECE setting.
Email eceobesity@cdc.gov for more information.

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