Early Care and Education (ECE)
More than 1 in 5 U.S. children ages 2 – 5 years are overweight or have obesity.
Most young children spend time in care outside of their home, making the ECE setting one of the best places to reach young children with obesity prevention efforts.
- More than 60% of children 3-5 years olds are in a non-parental care arrangement on a weekly basis. 1
- More than 11 million children under age 6 spend an average of 30 hours in non-parental care, with children of working mothers spending almost 40 hours a week in such care. 2
The Monthly Obesity Prevention in ECE Networking Call and News Blast shares expertise and resources around improved nutrition, physical activity, and obesity prevention in the ECE setting. Email firstname.lastname@example.org for more information.
State ECE systems can promote standards that address nutrition, infant feeding, physical activity, and screen time. ECE facilities can implement practices and programs that support healthy eating and physical activity among young children. These improvements can directly affect what children eat and drink, how active they are, reduce their screen time, support moms who breastfeed, and build a foundation for healthy living.
CDC developed a framework for obesity prevention in the ECE setting known as the Spectrum of Opportunities [PDF-655KB]. The Spectrum outlines how a state’s ECE system can embed recommended standards and best practices for obesity prevention. The Quick Start Action Guide (April 2018) [PDF-512KB] guides users through the Spectrum, and provides action steps to plan or strengthen state-level efforts in obesity prevention.
CDC also provides funding, training, and technical assistance to a variety of organizations to carry out obesity prevention efforts for the ECE setting based on the Spectrum of Opportunities framework.
- The State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (1305) cooperative agreement funded all 50 states and the District of Columbia for 5 years. All grant recipients were required to promote physical activity in the ECE setting and many implemented nutrition standards in this setting.
- The Early Childcare and Education Obesity Prevention Program, a cooperative agreement with Nemours Children’s Health System, supports partnerships with state public health and ECE in 15 states.
- The Pediatric Obesity Mini-Collaborative Improvement and Innovation Network (mini CoIIN), a partnership with the Association of State and Public Health Nutritionists, made facility and state-wide improvements in the ECE standards and best practices in 13 states. Information on all 13 states is available here.
- The Childhood Obesity Research Demonstration Project (CORD) funded 3 grantees to link pediatric care providers with community settings like ECE facilities. Project grantees worked with 60 ECEs to provide training and technical assistance.
In addition, CDC tracks states’ obesity prevention efforts targeting the ECE setting, releasing the first ever ECE State Indicator Report in 2016.
This section provides tools and resources to help states, ECE systems, and public health practitioners promote good nutrition and physical activity in the ECE setting.
- Spectrum of Opportunities [PDF-665KB] 1-pager
- Quick Start Action Guide for State Efforts (April 2018) [PDF-512KB]
- Roadmap for the Spectrum of Opportunities
- Licensing and Administrative Regulations to Support Obesity Prevention in the ECE Setting [PDF-1.54MB]
- Increasing Access to Drinking Water and Other Healthier Beverages in ECE Settings [PDF-3.68MB]
- Caring for Our Children National Guidelines for Obesity Prevention Standards in ECE
- Institute of Medicine reports:
- Achieving a State of Healthy Weight Report: National Assessment of Child Care Regulations (2017)
- Go NAP SACC – Nutrition and Physical Activity Self-Assessment for Child Care
- National Farm to Early Care and Education Website
This section highlights successes from grantees at the state and local level to promote good nutrition and physical activity in the ECE setting.
- ECE Highlights from State Health Departments [PDF-283KB].
- Hawai’i Gathers Information About Early Child Care by Using a Carbon-Copy Survey [PDF-109KB]
- Michigan Early Child Care: Improving Nutrition and Physical Activity Standards [PDF-636KB]
- New Mexico Early Care and Education Centers Create Lasting Wellness Changes [PDF-638KB]
- North Dakota Department of Health Makes Healthy Living Easier for Young Children [PDF-460KB]
- Ohio Health Department Makes Healthy Food Choices Easier for Ohio Children [PDF-410KB]
- Alaska Child Care Workgroup Addresses Childhood Obesity [PDF-126KB]
- Lessons Learned from the Arizona Empower Program [PDF-3.55MB]
- Healthy Kids Healthy Future: State Examples and Success Stories.
- Wood County, Wisconsin, Childcare Providers Remove Breastfeeding Barriers
- Child Care Sites in York County, Maine, Move Toward Better Health
- Making Health Easier: Healthy Changes Start in Preschool – Los Angeles, CA (English)
- Making Health Easier: Healthy Changes Start in Preschool – Los Angeles, CA (Spanish)
- Early Childhood Program Participation Survey of the National Household Education Surveys Program (ECPP-NHES:2005). National Center for Education Statistics Web site. Accessed January 2, 2014.
- Laughlin, L. Who’s Minding the Kids? Child Care Arrangements: Spring 2011. Current Population Reports, P70-135. Washington, DC: U.S. Census Bureau, 2013. Available at https://www.census.gov/prod/2013pubs/p70-135.pdf [PDF-634KB]
- Page last reviewed: September 18, 2018
- Page last updated: September 18, 2018
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