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Preschool Parenting

​​​​​​​​​Information about the onset and patterns of risk behaviors associated with overweight and obesity during preschool years are showcased in the link below. Visit the section Desired Behaviors to learn about how to promote healthy active living during the preschool years.

​​View Preschooler ​Timeline​​​
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​Desired Behaviors

Based upon evidence, a number of desired behaviors were identified as critical to helping families foster healthy active living for their preschooler. For each desired behavior you can explore the evidence, learn what parents told us about these behaviors, identify opportunities to promote healthy behaviors at the point of care, revi​​ew how to start conversations and access messages and resources to support families. Also available to inform your counseling is the Onset and Patterns of Risk Behaviors for Preschoolers Timeline located above this section.​

Role Mo​deling:

Parents and family model healthy active living​

    Evidence

    Adults play a vital role in modeling their child's behaviors and creating physical and social environments that influence their child's nutrition, physical activity, and sedentary behaviors

    Of all the adults involved in the lives of young children, parents or guardians have the greatest influence on them.

    Parent Feedback

    ​​Parents were skeptical that they were so influential.

    Some parents did note that children were often interested in eating what was on their plate, and if they had healthy foods, their child was more likely to eat them. They could see how modeling was important.

    Opportunities for Care

    ​When providing anticipatory guidance about healthy active living, frame it as a family endeavor.

    Reinforce that parents are a child’s most important and influential role model.

    Conversation Starters

    ​How are you doing? Are you finding time to eat healthy and be active?

    What influence do you think your eating and activity have on your toddler?

    What influence do you think other friends and family have on your child’s healthy eating and activity?

    Related Parent Resources

    ​​HALF Message(s):
    Yes, it’s true! You are your child’s best role model. When you set a good example, your child learns healthy habits.

    HALF Resources:
    For realistic parent derived strategies about role modeling, refer parents to healthychildren.org/growinghealthyParenting Tips Preschoolers​

Routine​​s are Important:

​Establish and maintain healthy routines
Adequate Sleep
Regular meals
Daily physical activity

    Evidence

    ​​Parents should nurture routines for children that provide exposure to behaviors that are associated with obesity prevention.

    Three household routines were associated with a reduction in the risk of obesity. These routines were:

        Eating the evening meal as a family
        Getting appropriate amount of sleep
        Limiting screen time to <2 hours per day

    Sleep duration has been identified as a potential modifier of childhood obesity. Children who got less than 9 hours of sleep had 1.5 times the risk of being obese as those with 11 hours per night.

    Preschoolers should sleep between 11-13 hours every night.

    Preschoolers tend to eat regular breakfast, but by the time children enter elementary school, many children are skipping breakfast.

    Parent Feedback

    Parents were adverse to the word "schedule".

    Overall, parents had trouble making the link between routines and healthy active living. However, nap time was a valued routine.

    Many parents thought establishing routines was particularly challenging if they had multiple children with other schedules and demands.

    Opportunities for Care

    ​​Emphasize the importance of eating breakfast, having a family dinner, establishing a bedtime routine, and sleeping.

    Routines make it easier to do these activities. Identify strategies to help the family establish and maintain routines.

    Bedtime becomes more challenging as children are weaned off naps. It is important to maintain a consistent bed time routine.

    Conversation Starters

    ​What’s a typical day like in your family?

    Can you talk about any barriers you have to developing healthy routines at home?

    Can you tell me about a routine that is going well for you?

    Can you tell me about a routine that you would like to have in your life?

    Who makes the routines in your house?

    Can you describe your child’s after school routine and can you describe their bed time routine?

    Related Parent Resources

    HALF Message(s):
    Routines are important. One way to help you and your child stay healthy and happy is to stick to a routine. When your child knows what to expect, he’ll be more likely to behave. Setting up routines for mealtime, playtime, and sleeping time will help you manage your responsibilities as a parent, too.

    HALF Resources:
    For realistic parent derived strategies for establishing routines, refer parents to the following sections on healthychildren.org/growinghealthy:

        Quick Tips: Keep Your Child Healthy widget. Simply select Routines and Schedules to generate the results.

        Parenting Tips Preschoolers

    Also take advantage of the HealthyGrowth app​ to create personalized patient education for your patient.

​​​Buildin​​​​​g a Team

Parents engage family and friends to help their child eat healthy and be active
Parents and childcare workers work together to provide healthy foods and active play

    Evidence

    Many children share meals and activities with other family members and friends.

    48% of children ages 0–4 with employed mothers were primarily cared for by a relative—their father, grandparent, sibling, or other relative - while she worked.

    24% percent spent the most amount of time in a center-based arrangement (day care, nursery school, preschool, or Head Start).

    14% were primarily cared for by a nonrelative in a home-based environment, such as a family day care provider, nanny, babysitter, or au pair.

    Parent Feedback

    Parents regularly identified family members (spouses and grandparents) as saboteurs and influencers that impact their ability to promote and integrate healthy active habits into their lives.

    In general, parents felt more comfortable approaching child care providers to talk about healthy active living values when the childcare provider was paid.

    If this service was provided in kind by family or friend, it was more challenging.

    There was sensitivity about offending the provider regardless of whether they were paid or unpaid.

    Opportunities for Care

    ​​Assess parent and family support around healthy active living and identify barriers around healthy eating, routines, and activity.

    Remind parents that everyone loves the child and wants what is best for them. That is usually a great place to start these discussions.

    Ask about their comfort level with their childcare situation and ask if they feel supported in their healthy active living goals.

    Let families know that it is their prerogative to negotiate healthy active living for their preschooler.

    Provide an example conversation starter for the parent when speaking to a child care provider: Thank you for all you do to care for our baby. We are so grateful. We were recently at the doctor and discussed…… can you help us with this goal?

    Conversation Starters

    ​You’ve assumed an important job in raising your child. Is there anything/anyone that’s making your job difficult?

    Can you tell me what family members or friends share meals and/or physical activity with your child?

    Can you tell me how you feel about the influence of family and friends on meals and activity time?

    How does it feel for you to talk to your family and friends about your desires for a healthy active life for your child?

    Does your child’s eating or activity behavior change when they with family or friends?

    How are things going with childcare?

    Do you know what and how much your child is eating?

    Do you have any concerns?

    What are your feelings on talking about healthy food and activity with your childcare provider?

    Is there anything that we could talk about today that would help you feel more comfortable talking to your childcare provider?

    Related Parent Resources

    ​HALF Message(s):
    Get your family on your team!

    HALF Resources:
    For realistic parent derived strategies about parents and childcare providers working together, refer parents to healthychildren.org/growinghealthyParenting Tips Preschoolers​

    Related HALF Messages:
    If your child is in preschool or daycare, talk to the teachers so they know what foods you want your child to eat. You may need to have the conversation more than once. Don’t feel like you are being annoying or pushy — you are the parent!


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