Child Care

Over 300,000 children in Arizona are cared for outside their home, yet regulations to ensure a healthy, active environment for proper development are lax. Children ages 0-5 are an ideal population to reach because their impressionability provides a window to shape healthy lifestyle behaviors before unhealthy ones can be established. If widely implemented, enhancing childcare facility regulations to require regular activity and healthy foods has great potential in early obesity prevention.

1. Water is required to be freely available in both child care centers and homes

2. Sugar sweetened beverages are limited (cannot replace juice with sugar sweetened beverages- homes only)

3. Foods of low nutritional value are limited in homes only

4. Children are not forced to eat in both child care centers and homes

Currently, Arizona licensing regulations do not require any minimum amount of physical activity.

The Nutrition and Physical Activity Self Assessment for Child Care (NAP SACC) is an intervention in child care centers aimed at improving nutrition and physical activity environment, policies and practices through self-assessment and targeted technical assistance. Developed at the University of North Carolina - Chapel Hill with CDC funds, this is a promising development in targeted nutrition and physical activity promotion.

First Things First Early Childhood Health and Development Board is also funding Child Care Health Consultation (CCHC) for a limited number of child care centers throughout Arizona. These are highly trained and certified nurses that will work with child care centers to improve all health related elements in their centers, from training to policy.

Potential Policy Improvements

1. The Nutrition and Physical Activity Self Assessment for Child Care (NAP SACC) and the Child Care Health Consultation programs should be encouraged for all child care centers.

2. Encourage more activity by requiring a minimum age appropriate amount of daily physical activity/structured play and limiting screen time (periods of inactivity): Without these kinds of regulations, there is nothing to prevent a facility from placing a child in front of the TV all day long.

3. Limit foods of low nutritional value, including sugar sweetened beverages and eliminate food as a reward: Not only is it important to change the types of foods that are fed, but how they are presented can also shape a child's perception of food, for better or worse.

4. Support breastfeeding or the provision of breast milk: Policies that promote feeding friendly environments could increase the duration of breastfeeding and promote a host of pro-health effects, including attainment of a healthy weight.

5. Enhance regulatory oversight/enforcement - none of these purposed policies will be able to realize their potential impact unless a regulatory authority is given enough oversight to see that they are adhered to.

Resources/Literature

• The American Academy of Pediatrics makes several recommendations in their Bright Futures series available here: http://brightfutures.aap.org/

• Information on NAP SACC is available here:
  http://www.napsacc.org/public/nap-sacc/background.asp