How can licensing regulations support best practices for obesity prevention in early care and education settings?


In all 50 states and the District of Columbia, early care and education (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 health and safety rules are followed by all ECE programs. Licensing regulations 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.

Teacher explaining fruits to students in classroom

High-impact obesity prevention standards in ECE programs

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

What information does the ECE licensing scorecard provide?

CDC’s State Licensing Scorecards are a tool for assessing how well a state’s licensing regulations for child care centers fully support the 47 high-impact obesity prevention standards. Scores are based on a state’s most recent licensing regulations and include four obesity prevention sub-domains:

  1. Healthy Infant feeding
  2. Nutrition
  3. Physical activity
  4. Screen time limits

How are the scorecards used?

Each state’s licensing scorecard can help identify where center-based ECE regulations support high-impact obesity prevention practices, and where there is room to improve. The scorecards can be used several ways:

  • Child care licensing officials and decision makers can plan and prioritize childhood obesity prevention efforts in their state. When states open their licensing regulations for regular updates, the scorecards provide detailed information on where ECE licensing regulations could be strengthened to more fully support healthy eating and physical activity policies and practices related to obesity prevention in licensed ECE programs. Decision makers can consult with their local public health department and healthcare professionals to learn about science-based recommendations for preventing obesity in ECE settings.
  • ECE directors and teachers can ensure that they are meeting all of their state’s obesity-prevention licensing standards, and review the full list of standards to see where they can put into action additional standards not required by their state’s licensing regulations to support the health of the children in their care.
  • Parents and caregivers can learn about their state’s licensing regulations around infant feeding, nutrition, physical activity, and screen time in ECE programs, and discuss how these standards are being implemented with their child’s ECE providers. The scorecards can also be used as conversation-starter to discuss other ways their ECE program is supporting nutrition and physical activity.
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