HealthyKidsHealthyFuture

1. CACFP National Professional Association Conference St. Louis, MO April 2, 2014 Disclaimer: The findings of this presentation are the conclusions of the presenter and do not necessarily represent the official policies of the CDC nor does the mention of any names or organizations imply endorsement by the Federal government. www.HealthyKidsHealthyFuture.org

2. Session Objectives After participating in this session participants should be able to answer the following questions: • What are best practices for obesity prevention in child care? • What steps should child care providers take to meet the 5 LMCC goals? • What kinds of free tools and resources are available through LMCC to help providers improve nutrition, physical activity, screen time, and breastfeeding support in child care?

3. Photo source: www.obesityinamerica.org Obesity Common Costly Solvable

4. What about young children? • Too many U.S. preschoolers (2 – 5 years) are obese • 23% are overweight or obese (~4% decline) • Why still important? • Overweight 5 years olds 4x as likely to become obese (January 2014; NEJM)

6. Changes in Our Society & Environment More TV watching Less physical activity More labor assisting devices Lack of sidewalks Automobile travel Perception of safety Calories out • More foods with high calories • Growth of the food industry and advertising • More meals away from home • Extraordinary portion sizes • Consumption of soda & sweetened beverages Calories in 6

7. Moving Forward, Reverse the Trend “ … we know the cure for this. This isn't like putting a man on the moon or inventing the Internet - it doesn't take some stroke of genius or feat of technology. ... Rarely in the history of this country have we encountered a problem of such magnitude and consequence that is so eminently solvable.” Michelle ObamaFebruary 9, 2010

8. Healthy Eating Physical Activity Healthy Kids, Ready to Learn

9. Why obesity prevention in child care and early education programs? • Habits form early. • Prevention must start early. • 11 million children spend 30 hours/week in care. • You are in a unique position to educate providers.

10. Let’s Move! Child Care Overview • One component of the First Lady’s Let’s Move! initiative to solve the obesity problem • Supports providers to adopt best practices in 5 goal areas through free resources and interactive, online tools • Recognizes providers who meet best practices

11. 5 Let’s Move! Child Care Goals 1 Physical Activity 2 Screen Time 3 Food 4 Beverages 5 Infant Feeding

12. Physical Activity Best Practices • Infants:Short supervised periods of tummy time several times each day (3-5 min, longer as tolerated) • Toddlers & Preschoolers: Active play time every day, both indoor and outdoor • Toddlers: 60 – 90 minutes or more (for half-day programs, 30 minutes or more) • Preschoolers: 120 minutes or more (for half-day programs, 60 minutes or more)

13. Benefits of Physical Activity • Helps children stay at a healthy weight • In childhood • In adulthood – physical activity habits learned in early childhood can last a lifetime

14. Benefits of Physical Activity • Helps children: • Develop motor skills and build their strength, flexibility, and endurance • Develop and maintain strong bones • Improve social skills and brain development • Sleep better • Feel confident about themselves and their bodies • Reduce their risk of feeling stressed or depressed

15. Kinds and Intensity of Physical Activity KINDS • STRUCTURED: Organized, quick, and intense activities led by adults • UNSTRUCTURED: Free Play to stimulate the imagination and creativity INTENSITY Moderate to vigorous physical activity MVPA (aka ‘breathless’ play)

16. Screen Time Best Practices • Infants: No screen time • Toddlers: No more than 3 – 4 times per year, or never • Preschoolers: Only for educational or physical activity purposes • No more than 30 minutes per week or never, while in your care • Work with families to ensure no more than 1 - 2 hours per day

17. Screen Time Best Practices • Parents: • Provide screen time reduction and/or media literacy education to parents at least twice a year, • Special programs, newsletters, information sheets, etc.

18. Rationale • Gets in the way of exploring, playing, and social interaction. • As kids get older, gets in the way of: • being active • reading • doing homework • playing with friends • spending time with family • Kids who spend more time watching TV are more likely to be overweight or obese.

19. When screen time is allowed: • Make it “quality programming” by choosing shows or computer games that are educational or get kids moving. • Track screen time with a simple scheduling sheet so you know how much screen time a child has and when they’ve reached their limit for the week. • Avoid watching while eating (snacks or meals). REMINDER: Touch screen technology does NOT count as ‘active’ screen time. Also, watch the quality of children’s movement with active video games

20. Food Best Practices • Toddlers and preschoolers • Servea fruit and/or a vegetable at every meal • Juice doesn’t count as fruit* • French fries, tater tots, and hash browns don’t count as vegetables!* *Conflicts with CACFP meal requirements • Limit fried and pre-fried foods: no more than 1/month • French fries, tater tots, hash browns, potato chips, frozen and breaded meats or fish

21. Food Best Practices • Preschoolers: • Serve all meals family style when possible so that children are encouraged to serve themselves with limited help.

22. Food • Helps children stay at a healthy weight • Food preferences develop at an early age, even in infancy • Opportunity to teach kids’ taste buds to appreciate healthy foods

23. Food • Benefits of family-style dining • Improve skills for self-feeding and recognition of hunger cues • Promotes and supports social emotional, and motor skill development • Language skills improve as adults and peers talk with each other

24. Food • Benefits of family-style dining • Opportunity for positive role modeling • Adults at the table help prevent fighting, feeding each other, potential choking, and other negative behaviors

25. Beverages Best Practices • Water: Visible and available inside and outside for self-serve • Fruit juice: Only100%; limited to no more than 4 – 6 oz. per day per child* and encourage parents to support this limit *Conflicts with CACFP meal requirements • Sugary Drinks: Never (includes fruit drinks, sports drinks, sweet tea, and soda) • Milk: Serve only 1% or non-fat (skim) milk to children 2 years and older (unless otherwise directed by the child’s health provider)

26. Beverages • Water keeps kids hydrated best • Water helps to reduce acid in the mouth that can cause cavities • Sugary drinks are high in calories and low in nutrients • Drinking water instead of sugary drinks reduces the amount of calories children consume

27. Beverages • Serving fresh fruit instead of fruit juice is best, because it is high in dietary fiber and is a natural source of energy • Skim or 1% milk have the same amount of calcium and other essential nutrients as whole milk, but less fat and calories

28. Infant Feeding Best Practice Have a private room for moms to breastfeed or pump • other than a bathroom • appropriate seating and privacy Have the space available for mothers who want privacy; but allow breastfeeding openly too.

29. Take A Look • Drop of formula vs. Drop of breast milk • White blood cells protect against infection • Fat globules help eyes and brain grow faster

30. Create a space for breastfeeding or expressing milk • Pick a private space other than a bathroom • A privacy barrier could be: • Door • Curtain • Room divider

31. Breast Feeding Provide training on handling of breast milk for providers Expressed milk is food from home NOT bodily fluid requiring special precautions Create breastfeeding friendly signs and handouts to encourage mothers who choose to breastfeed to continue

32. Sign Up & Let’s Move! Child Care Quiz

33. Visit www.HealthyKidsHealthyFuture.org

34. Simple Steps Become a Recognized Let’s Move! Child Care Provider & celebrate your success! Yes Sign up Take Checklist Quiz Meet all best practices? No Build action plan Make changes in plan Use free online resources & tips

35. Centers and providers can post their participation certificate to let families know the goals they’re working towards!

36. Take the Checklist Quiz Providers can see where they are and make a manageable action plan to achieve the LMCC goals Look for the ‘Take Action’ box on the homepage.

37. Checklist Quiz Providers answer questions to see which best practices they are meeting and which goals they need to work on Available in Spanish too!

38. Action Plan using the Checklist Quiz • Action Planning is an important step in making changes • Providers choose their priorities • Start where they are; where the program is most likely to be successful • Be ready to create individual action steps • Samples are available

39. Sample Action Plan

41. Recognized LMCC Providers: Get aRecognition Award Are Featured on the LMCC Map

42. What Kind of Resources Can Providers Find? • Curricula • Training videos • Menu Planning & Recipes • Activity Sheets • Parent Handouts • Tips to eat healthier and be active • CACFP specific resources • And more!

43. Free Online Trainings for Providers More trainings coming soon!

44. Slide sets for Trainers • Overview of LMCC and 5 in-depth slide sets for each of the 5 LMCC goal areas • Best practices & rationale • Tips & Resources • Activity ideas • Videos & ideas for handouts

45. Ideas and Resources • Ideas and resources are key to improving healthy environments for young children • Available resources include: • Webinars • Tips and encouragement • Activities • Provider successes • External child care resources websites

46. Healthy Eating • Healthy Eating and Physical Activity tabs offer: • Tips, resources, online tools and activities • Educational information: • Videos • Articles • Parent resources • Suggestions for programs to meet components of LMCC goals: • Policies • Practices

47. Sample Resources • Articles from KidsHealth.org • Toolkits and Guides

48. Tip Sheets

49. Books to encourage healthy habits Read this tale about water to kids!

50. Videos • Supporting Breastfeeding Moms • Adding Physical Activity to Your Daily Routine • Starting Family Style Dining