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Fall 2011 Vol. 11 Number 2

Table of Contents

Just Baby Fat?

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Habits for Healthy Weight Need to Start Young

Few things stir greater delight in new parents than a smile framed by their infant’s chubby cheeks. But for an increasing number of American babies and toddlers, those cherubic features may signal extra pounds that will stay with them into adulthood.

The rate of excess weight among children ages 2 to 5 has doubled since the 1980s. Currently, slightly over 20 percent are overweight or obese, and about 10 percent of children from infancy to age 2 carry excess weight, according to a report by the Institute of Medicine on policies to prevent early childhood obesity.

Concerns about extra pounds on babies and toddlers fly in the face of long-held convictions that a pudgy baby is a thriving baby and that young kids naturally grow out of their baby fat as they learn to walk and become more active. But the same factors that promote weight gain among older children and adults — an increase of sedentary behaviors, overconsumption of calories, and insufficient sleep — are contributing to persistent excess weight among too many of the youngest children.

The problem cannot be solved by tackling any one factor by itself, the report stresses. It recommends a range of steps that should be taken by pediatricians, preschool teachers and child care providers, nutrition program officials, and others responsible for guiding children’s development and activities. These actions focus on identifying when young children show signs of putting on too much weight, promoting healthy eating, increasing physical activity, and ensuring adequate sleep.

Studies show that many parents do not understand the consequences of extra pounds on infants and young children and do not see baby fat as a potential problem. Health professionals therefore should measure infants’ and young children’s weight and height as a standard procedure at every well-child visit. They should be able to recognize signs of excess weight and discuss the health risks with parents.

Pediatricians, early childhood educators, and child care professionals also need to be trained to counsel parents about age-appropriate sleep times and habits. Sufficient sleep is associated with healthy weight, and the amount of sleep obtained by children under age 3 has declined notably in recent years.

In addition, preschools and child care facilities must buck the trend toward increasing sedentary behaviors by creating space and resources for physically active play and limiting the time children spend watching television and using digital devices or being confined to strollers and swings. It is up to the agencies that regulate child care facilities to determine appropriate standards, the report notes, but they could include requiring facilities to ensure their charges are physically active for at least a quarter of the time spent in care and restricting the use of cribs, car seats, and high chairs to their intended purposes.

Health care providers, preschool educators, and child care professionals also can do more to help instill good dietary habits at an early age. Health care professionals and organizations should step up efforts to support breast-feeding. Regulatory agencies should ensure that all child care facilities and preschools follow the meal patterns established by the federal Child and Adult Care Food Program, which reflect age-appropriate amounts of sugar, salt, fat, and necessary nutrients and promote consumption of fruits, vegetables, and whole grains.

“The obesity epidemic is not sparing the youngest children,” said Leann Birch, chair of the committee that wrote the report. “But there are effective ways to reduce the risk for obesity by creating healthy environments and implementing positive practices during the crucial early years of development,” she said.  -- Christine Stencel

Early Childhood Obesity Prevention Policies. Committee on Obesity Prevention Policies for Young Children, Food and Nutrition Board, Institute of Medicine (2011, 191 pp.; ISBN 0-309-21024-0; available from the National Academies Press, tel. 1-800-624-6242; $49.00 plus $5.00 shipping for single copies).

The committee was chaired by Leann Birch, Distinguished Professor of Human Development and director, Center for Childhood Obesity Research, Pennsylvania State University.The study was funded by the Robert Wood Johnson Foundation.

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Copyright 2011 by the National Academy of Sciences