Limiting television and other media use, encouraging infants and young children in preschool and child care to spend more time in physically active play, and requiring child care providers to promote healthy sleeping practices are some of the actions needed to curb high rates of obesity among America’s youngest children, says a new report from the Institute of Medicine.

The report recommends steps that should be taken by child care centers, preschools, pediatricians’ offices, federal nutrition programs, and other facilities and programs that shape children’s activities and behaviors. Although the recommendations are directed to policymakers and health care and child care providers, these professionals can counsel and support parents in promoting healthy habits in the home as well, said the committee that wrote the report.

About 10% of children from infancy to age 2 and slightly over 20% of children ages 2 through 5 are overweight or obese. The rates of excess weight and obesity among children ages 2 to 5 have doubled since the 1980s.

"Contrary to the common perception that chubby babies are healthy babies and will naturally outgrow their baby fat, excess weight tends to persist," said committee chair Leann Birch, distinguished professor of human development and director, Center for Childhood Obesity Research, Pennsylvania State University, University Park. "This is a national concern because weight-related conditions such as diabetes and high blood pressure once occurred almost exclusively in adults but are now occurring at rising rates among teens and young adults. Child care providers, health professionals, and policymakers can be helpful partners to parents in reducing obesity risk by creating healthy environments and implementing positive practices during the crucial early years of development."

Obesity cannot be solved by tackling only one factor, the committee said. It requires a multipronged approach that includes identifying when young children show signs of excess weight, promoting healthy eating, increasing physical activity, and ensuring adequate sleep.

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.