Chubby cheeks for babies may not be so cute after all. A report released Thursday afternoon by the Institute of Medicine offers a stark reminder that obese babies often become obese adults — and a series of simple steps could help reverse the trend.
Designed to combat the “widespread belief” that childhood obesity doesn’t kick in until kindergarten, the IOM report lays out recommendations to help keep kids fit from birth to age 5. More sleep, more play time, less formula and less television top the list of ways to keep the baby fat at bay (see more of the study’s tips below).
“For too long, people didn’t worry about obesity in very young children. A big baby was supposed to be a healthy baby,” said Dr. Leann Birch, chair of the IOM’s Committee on Obesity Prevention Policies for Young Children. “But kids don’t necessarily grow out of it. They become more obese with age.”
Only recently did researchers discover that 10 percent of infants and 20 percent of preschoolers are overweight, said Birch, who also directs Pennsylvania State University’s Center for Childhood Obesity Research.
“Obesity hasn’t somehow spared our youngest,” she said.
Read the tips for fighting obesity in young children after the jump.
The report focuses particular attention on the role of caregivers, preschool teachers, pediatricians and policymakers in helping babies and toddlers avoid unhealthy weight gain. Those individuals then have a responsibility to share health tips with parents, the report says.
“We really see that obesity is a multi-factorial problem. We need to look beyond families,” Birch said.
For example, pediatricians should monitor a child’s weight in relation to height, recommend healthy eating habits and stress the importance of breast feeding — all activities known to reduce obesity, the report states. Child care providers should limit media use, offer nap time and sprinkle plenty of physical play time throughout the day. And policymakers should ensure all children have consistent access to healthy food through federal programs, develop nutrition guidelines for children under 2, and launch a media campaign to help spread the message about early childhood obesity.
If learned early, healthy habits become the norm for children, said Debra Haire-Joshua, a committee member and professor at Washington University in St. Louis.
“You’re not changing behaviors,” she said. “You don’t have to re-teach someone how to eat appropriately or not overeat – they just learn how to do it right from the start.”
IOM’s Top Tips for Healthy Babies
Identifying At-Risk Children
Studies show that many parents do not understand the consequences of excess weight in infants and young children or are not concerned about early excess weight or obesity.
Health professionals should measure infants’ weight and length and the body mass index of young children as a standard procedure at every physician visit.
- They should identify children at risk for obesity and discuss with parents their children’s measurements and the risks linked to excess weight.
Evidence points to a relationship between insufficient sleep and obesity. Data indicate that over the past two decades there has been an overall decrease in the amount of sleep infants and children get, with the most pronounced declines among children less than 3 years old.
Regulatory agencies should require child care providers to promote healthy sleep durations in their facilities, the report recommends.
- Pediatricians, early childhood educators, and other professionals who work with parents need to be trained to counsel them about age-appropriate sleep times and good sleep habits.
Physically Active Play and Sedentary Activities
Agencies that regulate child care facilities should require child care providers and early childhood educators to create opportunities and environments that encourage infants, toddlers, and preschoolers to be physically active throughout the day.
Child care providers could engage children in physically active play for a cumulative average of at least 15 minutes per hour spent in care, joining children in their activities, and getting children outdoors to play when and where possible. They also could avoid using restriction of play as a disciplinary measure.
Infants should be allowed to move freely with appropriate supervision.
- Use cribs, car seats, and high chairs only for their intended purposes and limiting use of strollers, swings, and bouncing chairs.
Child care providers should limit television viewing and use of computers, mobile devices, and other digital technologies to less than two hours per day for children ages 2 to 5.
Child care facilities and preschools could advance this goal by restricting screen time of any form to 30 minutes in half-day programs and one hour in full-day programs.
- Health care providers could counsel parents on the benefits of restricting screen time.
Given that only 13 percent of mothers breast-feed exclusively for six months after birth, and only 22 percent continue breast-feeding up to a year, health care providers and organizations should step up efforts to encourage breast-feeding, the report says.
All child care facilities and preschools should be required to follow the meal patterns established by the federal Child and Adult Care Food Program (CACFP), which reflect age-appropriate amounts of sugar, salt, and fat and necessary nutrients. CACFP standards promote fruits, vegetables, and whole grains and provide guidance on appropriate portion sizes for children at different ages.
The U.S. departments of Health and Human Services and Agriculture should establish dietary guidelines for children from birth through age 2.
- Government officials should take steps to boost participation in nutrition assistance programs. More than one-third of those eligible for the Supplemental Nutrition Assistance Program and 40 percent of those eligible for WIC — a nutrition program aimed at women, infants, and children — do not take advantage of them.