Healthy Children, Healthy Weights CHILD CARE ACTION KIT Developing a healthier environment for children to live, learn and play at their best. Developed by Healthy Children, Healthy Weights at Columbus Public Health 240 Parsons Avenue, Columbus, Ohio 43215 | Phone: 614-645-7520 http://publichealth.columbus.gov/healthy-children-healthy-weights.aspx Our mission To prevent childhood overweight and obesity and promote healthy weight and growth in all children in Ohio, starting with the youngest age group – birth to five years old. Our vision All children in Ohio have daily opportunities for active play and access to nutritious foods that lead to children entering kindergarten ready to live, learn and play at their best. Healthy Children, Healthy Weights welcomes any questions or feedback. To reach us, please call 614.645.7520 or visit our website at Columbus.gov/hchw The Action Kit can be downloaded from the Healthy Children, Healthy Weights page by visiting Columbus.gov/hchw and clicking on the link, "Child Care Action Kit,” in the Tools and Resources page. PROGRAM BACKGROUND Healthy Children, Healthy Weights (HCHW) is designed to prevent childhood overweight and obesity by promoting healthy weight and growth in all children, starting with the youngest age group - birth to five years old. The program was piloted in 2003-2004 and received a National Association of County and City Health Officials (NACCHO) model practice award in 2005. In 2008, The Centers for Disease Control (CDC) and Prevention concluded that HCHW Child Care was both evidence-based and theoretically grounded. The curriculum aligns with Let’s Move! Child Care and is an endorsed program of the Let’s Move! Campaign. HCHW was a 2012 honorary presenter at the Weight of the Nation national conference, hosted by the CDC, and 2015 presenter at the American Public Health Association annual conference. 5 Program Goals 1. Increase physical activity Provide opportunities for at least 1-2 hours of play each day and include a combination of both structured and unstructured play. Physical activity is not only important for keeping children at a healthy weight; it promotes physical, cognitive and emotional 10 development. 2. Reduce screen time Limit screen time, including TV, computers, video games and apps, to no more than 30 minutes/week during child care for children age 2 and up. No screen time for children under age 2. According to the Institute of Medicine, screen time is associated with 10 inactivity, decreased metabolic rates and increased risk of being overweight. 3. Establish healthy eating habits Serve a variety of whole fruits and vegetables, offer more whole grains, avoid serving fried foods and eat meals family style whenever possible. Eating whole, nutrient dense foods instead of fried foods has been shown to reduce calorie intake.4 Also, eating meals family style is associated with better eating habits such as increasing fruit and vegetable 1 intake and decreasing fried food and soda consumption. 4. Promote water first for thirst Offer water first when a child says they are thirsty, avoid sugary drinks and serve unflavored non-fat or low fat milk to children age 2 and up. Sugar sweetened beverages are the primary source of excess sugar in the American diet.10 Serving water is an important component in promoting a healthy weight since it is sugar, caffeine and calorie 13 free. 5. Welcome breastfeeding Provide a private and sanitary place for mothers to breastfeed or express milk and supply breast milk to infants of mothers who wish to breastfeed. Breastfeeding has been shown to reduce risk for several illnesses. Its duration is also inversely related with 4 pediatric obesity. ACTION KIT INTRODUCTION Child care providers have a unique and important role in the development of the children in their care. From social and emotional development to educational growth, child care providers play a significant role in the lives of young children and are one of the earliest resources for parents. Among the greatest impacts a child care provider can have is the development and promotion of healthy habits in early childhood that can create life-long healthy outcomes. The resources available in this Action Kit promote the five Healthy Children, Healthy weight program goals. Throughout this document are a lists of activities found in the Healthy Children, Healthy Weights (HCHW) Ring of Fun for each age group (infants, toddlers, preschoolers and school agers). The Ring of Fun activities extends HCHW’s key messages into the classroom through physical activity, healthy nutrition, gardening and parent engagement. Activities are age-appropriate and follow Let’s Move! Child Care, American Association of Pediatrics, Institute of Medicine, National Association for Sport and Physical Education, Academy of Nutrition and Dietetics and 2015 Dietary Guidelines for Americans’ recommendations for the healthy development of infants, toddlers, preschoolers and school agers. HCHW is designed to prevent childhood overweight and obesity by promoting healthy weight and growth in early childhood. On behalf of HCHW staff, we would like to thank you for your commitment to growing healthy children. TABLE OF CONTENTS Ohio Healthy Program Healthy Policies How to become an Ohio Healthy Policy Guideline Handbook 131 Program (OHP) 1 Frequently asked questions 133 How to apply 3 Healthy Families How to renew 5 Family Engagement Handbook 149 Healthy Activity Frequently asked questions 150 Frequently asked questions 9 How to Communicate with Families 151 Ring of Fun activities Additional Tools and Resources 153 -- Infants 11 Key Message Campaigns -- Toddlers 15 o Make Snacks Count 155 -- Preschoolers 20 o Reduce Screen Time 157 -- School Agers 25 o Make Each Plate a Healthy Plate 159 Healthy Eating o Build Children Up with Words 161 Frequently asked questions 31 o Growing Great Tasters 163 Ring of Fun activities o An Hour a Day to Play 165 -- Infants 34 o Water First for Thirst 167 -- Toddlers 37 o Take Time for Meals 170 -- Preschoolers 42 o Make Breakfast Count 172 -- School Agers 47 o Healthy Celebrations 174 Healthy Growing o Good Rest is Best 176 Frequently asked questions 49 o Cold Weather Fun 178 Ring of Fun activities Ring of Fun activities -- Infants 53 -- Infants 180 -- Toddlers 55 -- Toddlers 185 -- Preschoolers 58 -- Preschoolers 189 -- School Agers 61 -- School Agers 193 Healthy Menus References & Resources 199 Frequently asked questions 65 Child and Adult Care Food Program 71 (CACFP) & OHP Handbook Choking Prevention 107 Sample 4 Week Cycle Menu 109 Recipes 117 Sample Snack Menu 122 Sample Lunch Packing List 124 What is a Whole Grain? 125 Ohio Produce List 129 HOW TO BECOME AN OHIO HEALTHY PROGRAM There are four steps in becoming an OHP. They include: STEP 1. Attend the Ohio-Approved Healthy Children, Healthy Weights (HCHW) trainings*. Session 1: Healthy Habits, Parts 1-4 Attended by home child care providers or one staff person from each age level represented at their child care center (note: all four parts must be completed). Session 1 includes: 1. Healthy Activity Participants will discuss current childhood obesity rates and health risks and learn the importance of providing physical activity opportunities in child care settings. This session provides participants with ideas and the opportunity to share practices on both structured and unstructured play. They will walk away with knowledge on how to link Early Learning Development Standards to classroom activities while providing opportunities for physical activity. 2. Healthy Eating The role of how adults support children in feeding and eating will be discussed. Participants will learn basic nutrition and tips on how to encourage new foods in a healthy manner. This session provides participants with ideas on healthy snacks and positive drink choices, and how to support water first for thirst. Participants will walk away with ideas on how to link the Early Learning Development Standards to classroom activities while providing nutrition education to children. 3. Healthy Growing Adults are powerful role models. They can promote positive body image and encourage the creation of self-esteem in children. Participants will discuss what constitutes a healthy body weight for children. Ideas for healthy growing will be further explored through discussion of how healthy food can be grown in child care settings. Participants will learn how to link Early Learning Development Standards to classroom gardening activities and recognize how language (words) affects children’s self-esteem. 4. Healthy Families This last part of the Healthy Habits series focuses on strategies to encourage parent outreach. Participants will review the HCHW 12 key messages that promote healthy habits for the children and develop skills for talking to families about taking these messages home. Participants will walk away with knowledge on how to host a healthy celebration in their classroom, and how to engage families in a month-long health campaign at their center. 1 Session 2: Healthy Menus Attended by the home provider, cook and/or person planning the menus Participants will discuss healthy eating behaviors and what to consider when feeding young children. They will gain knowledge and know-how on planning a healthy menu, walk away with new ideas and shared experiences of recipes and how to make menus healthier on a budget. Tips will be given to ensure variety and balance. Session 3: Healthy Policies Attended by the home provider, administrator or director This session focuses on creating a healthier child care environment through policy. Participants will discuss ways to craft an atmosphere where kids can grow, learn, and play at their best. They will gain an understanding of the importance of healthy policies in sustaining a healthy environment and ideas on how to adopt and implement a new healthy policy successfully. STEP 2. Implement a policy to ensure healthy practices are maintained in the program. (See the Policy Guideline Handbook under Healthy Policies).