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Section on Early Education and Child Care Program

Section on Early Education and Child Care Program Hot Topics in Early Childhood Influencing Early Education and Child Care: Research, Early Literacy, Obesity Prevention Session # H2068 Danette Swanson Glassy, MD, FAAP

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Section on Early Education and Child Care Program

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  1. Section on Early Education and Child Care Program Hot Topics in Early Childhood Influencing Early Education and Child Care: Research, Early Literacy, Obesity Prevention Session # H2068 Danette Swanson Glassy, MD, FAAP Caring For Our Children, 3rd Edition, Co-ChairExecutive Committee, Section on Early Education and Child Care Clinical Professor, University of Washington, School of Medicine Mercer Island Pediatrics Mercer Island, Washington

  2. Disclosures In the past 12 months, I have not had a significant financial interest or other relationship with the manufacturer(s) of the product(s) or provider(s) of the service(s) that will be discussed in my presentation. This presentation will (not) include discussion of pharmaceuticals or devices that have not been approved by the FDA or if you will be discussing “off-label” uses of pharmaceuticals or devices.

  3. Agenda HRSA Early Childhood 2010: Innovations for the Next Generation Preventing Childhood Obesity in Early Care and Education Programs: Caring For Our Children Nutrition, Physical Activity, and Screen Time Standards Applying the Standards

  4. Early Childhood 2010: Innovations for the Next Generation • www.earlychildhood2010.org • Jointly convened by the Department of Education and the Department of Health and Human Services • State and Local Partners • Workshops • Collaboration Meetings by State

  5. Early Childhood 2010: Innovations for the Next Generation • Topics: • Obesity Prevention including Let’s Move-Michelle Obama’s initiative to prevent obesity- www.letsmove.gov • Home Visiting • Quality Child Care • Healthy Workforce/Professional Development • Early Identification of development issues

  6. Caring for Our Children (CFOC) • Definitive source on best practice in health and safety in early care and education settings • Evidence-based • Expert consensus • Nationally recognized • Model for health & safety practices

  7. American Academy of Pediatrics (AAP) American Public Health Association (APHA) National Resource Center for Health and Safety in Child Care and Early Education (at University of Colorado Denver) (NRC) Funded throughMaternal and Child Health Bureau, Health Resources and Services Administration, USDHHS Cooperative Agreement (MCHB) Caring for Our Children (CFOC)Partners

  8. CFOC 2nd Edition (current edition) published in 2002 • 3rd Edition revision process underway – Full set to be released first quarter 2011 • Accelerated Nutrition, Physical Activity and Screen Time Standards– July 2010 nrckids.org/CFOC3/PDFversion/preventing_obesity.pdf www.aap.org/bookstorepubs.html

  9. Nutrition Panel - Primary responsibility for review, update and new information regarding nutrition and physical activity standards. Related Panels also reviewed & contributed from their disciplines – Child Development, Injury Prevention, General Health, etc.

  10. Pediatricians Maternal and Child Health Professionals Nutritionists Other Health Professionals Nursing, Social Work Breastfeeding Experts Physical Activity Experts Child Development Specialists Expert Panel Members

  11. NUTRITION variety of healthy foods promote positive mealtime environment PHYSICAL ACTIVITY daily indoor & outdoor activities SCREEN TIME limited Nutrition and Physical Activity Comprehensive Standards

  12. promote eating a variety of healthy foods advocate breastfeeding of infants emphasize and promote daily physical activity limit access to screen time partner with families to promote healthy eating practices and lifestyles encourage collaboration among families, caregivers, and community health partners How Standards Address Problem

  13. early identification of problem professional health team working with families to prevent obesity education environment – teaching and learning prevention and early intervention strategies promote goal of achieving standard of nutrition, physical activity, and limited screen time Opportunities for Early Care and Education Programs

  14. Nutrition Standards

  15. Encourage breastfeeding : Encourage mothers to breastfeed at the child care program – provide comfortable, private areas Train caregivers/teachers to support and advocate for breastfeeding. Implement policies and procedures on handling and feeding human milk safely – reduces mother’s anxiety and promotes safety for infants Nutrition Standards

  16. Feed infants on cue by consistent caregiver Accommodate use of soy formula and soy milk when necessary Use 2% milk for children 12 months to 2 years, for whom overweight or obesity is a concern with written documentation from health professional Nutrition Standards

  17. Nutrition Standards • Accommodate vegetarian diets • Serve small size portions • Availability of age-appropriate nutritious snacks • Caregivers are models of healthy eating habits • Provider sits with children during meal time and encourages socialization • Food is never used as a reward/punishment

  18. Water available throughout the day No fruit juice for children under 12 months 100% juice limited to 4-6 ounces for children 1– 6 years of age Whole fruits encouraged Nutrition education offered to children & parents Nutrition Standards

  19. Physical Activity Standards

  20. Promote development of infant movement skills – plenty of tummy time Promote active daily play for 1-6 year olds with: 2-3 outdoor occasions 2 or more structured activities over course of day (indoor and/or outdoor) Time for unstructured active play Physical Activity Standards

  21. Caregivers and teachers encourage and participate in physical activities: Lead structure activities Wear clothing that permits safe and easy movement Prompts children to be active Physical Activity Standards

  22. Limit restrictive movement Limit time in high chair to no more than 15 minutes (except for meals & snacks) Cribs are only for sleeping or resting Restricting active play as a punishment is not allowed Physical Activity Standards

  23. Screen Time Standards

  24. No TV, video, DVD and computer use under 2 years of age 2 years and older: Only 30 minutes per week of media time and only for educational/physical activity purposes Computer use – 15 minute increments; school age children may have longer for homework. Caregivers as role models – no TV watching during day Screen Time Standards

  25. Applying the Standards

  26. National and State Campaigns can use to build integrated nutrition and physical activity components in their systems. Caregivers/teachers can use to develop and implement practices and policies and use in staff training. Families can support and join with caregivers/teachers in the implementation of healthy practices. They can also reinforce at home. Using “Preventing Obesity” CFOC Standards

  27. Regulators can use to develop and/or improve state regulations that support the prevention of obesity and promote healthy habits. • Health care professionals can assist families and providers with sound evidence-based rationale for implementing and following healthy lifestyles. • Academic faculty can use standards as a resource to prepare students for entering the early childhood workplace.

  28. Applying the Standards Public Health, Seattle & King County grant: Communities Putting Prevention to Work from the CDC Community Pediatric Foundation of Washington with the Coalition for Safety and Health in Early Learning (www.cshelwa.org)

  29. King County Healthy Active Kids • Focus on sustainable policy changes in early learning settings and after school programs that improve nutrition, physical activity and screen time • Partners include Child Care Resources, Schools Out Washington, King County Parks and Recreation, City of Seattle, University of Washington Center for Public Health Nutrition, Seattle Children’s Hospital

  30. Two Activities • Develop and implement model child care health policies within King County which reflect best practice for nutrition and healthy active living in early learning and after school programs. Use these standards to improve state licensing regulations • Increase access to healthy food for child care providers

  31. Policy and Curriculum Tools • Preventing Obesity in Early Care and Education Settings: New Caring for Our Children Standards as the basis for the model policies • Current curriculum also used to meet the standards • Creation of a Crosswalk comparing the new CFOC standards with state regulations, Head Start regulations, and Child and Adult Food Program regulations

  32. Train-the-Trainers • Key to success is training-the-trainers: • Child Care Health Consultants • Head Start Health Specialists/Technical Advisors/Nutrition Specialists • After School Program Trainers from Schools Out, YMCA, Montessori Associations • State Licensors • Delaware report from Altarum

  33. Challenges and OpportunitiesRelated to Implementation of Child Care Nutrition and Physical Activity Policies in Delaware May, 2010 • Findings from Focus Groups with Child Care Providers and Parents • www.altarum.org/publications-resources-health-systems-research/CHOMP-Delware-Focus-Group-Report • Clearly and consistently communicate the rationale for nutrition and physical activity standards in child care. • Offer supports to help providers address the challenges of meal planning, food preparation, and food purchasing. • Develop new resources and expand on existing ones to help providers educate and engage preschool children in healthy eating habits and increased physical activity.

  34. Challenges and OpportunitiesRelated to Implementation of Child Care Nutrition and Physical Activity Policies in Delaware May, 2010 • Help providers implement strategies to successfully engage staff and parents. • Expand and improve training and technical assistance for child care directors and staff. • Develop and implement mechanisms for improved peer-to-peer information sharing. • Align state child care Quality Rating and Improvement Systems (QRIS) with enhanced nutrition and physical activity standards.

  35. Train-the-Trainers • Partnerships are essential • Facilitate provider trainings/provide continuing education credit • Child Care Resources • Schools Out Washington to help facilitate the trainings and provide continuing education credit • Provide ongoing technical assistance • Child Care Health Consultants • Head Start Technical Advisors

  36. State Policy Work • Credible Tool • Preventing Obesity in Early Care and Education Settings: New Caring for Our Children Standards • Crosswalk comparing the CFOC standards with current State Licensing Regulations, Head Start Regulations, Child and Adult Food Program Regulations • Top down strategy • Governor’s advisors • Legislators • Agency Heads: Department of Health, Department of Early Learning, Head Start Collaboration Office • Participate in the process for modifying Licensing Regulations

  37. State Policy Work Partnerships: • AAP State Chapter (see www.aap.org/member/chapters/chapserv.htm) • American Academy of Pediatrics Chapter Child Care Contacts: www.healthychildcare.org/cccc.html • Other Child Advocacy Organizations • Other Non Profit Organizations

  38. Increase Access to Healthy Foods • Farm to table programs • Bulk buying • Facilitated system

  39. Questions?

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