The recent Institute of Medicine Report Early Childhood Obesity Prevention Policies highlights what pediatricians know and have been struggling to address. The obesity epidemic is reaching our nation’s youngest children.

  • Almost 10 percent of infants and toddlers have high weights for length.
  • Slightly over 20 percent of children aged 2 to 5 are overweight or obese.
    Approximately one in five children is already carrying excess weight as he or she enters kindergarten.
  • Children who are obese at age six have been found to have a greater than 50% chance of being obese as adults, regardless of parental obesity status.

Additional literature suggests that the acceleration of the obesity problem occurs in the first years of life as lifelong dietary intake patterns, eating habits, sleep routines, and food preferences are established.


While the growing trend of obesity at even the youngest ages can be daunting, there is also opportunity for health care providers to shape this unique and more malleable developmental period in partnership with parents. During infancy and early childhood children are acquiring their eating, activity, and sleep patterns. These routines can be discussed and formed during the 15 recommended pediatric well child visits across a child’s first 5 years of life.

In addition, there is growing evidence that family environment and parental practices can be critical factors in creating or mitigating obesogenic environments for young children. A number of modifiable practices have been identified that influence obesity in infants through preschool children. These include:

  • Feeding practices such as:
    • breastfeeding,
    • appropriate bottle feeding,
    • introduction of complimentary foods,
    • fostering self-feeding,
    • quality and quantity of foods provided,
    • shared family meals,
    • understanding of hunger and satiety, and
    • use of controlling, rewarding or restrictive feeding practices.
  • Family routines such as:
    • time spent being physically active,
    • TV viewing habits,
    • eating out, and
    • appropriate sleep routines and habits.
  • Parent role modeling

Pediatricians can partner with families across those 15 well-visits to help parents build skills, tactics, and strategies to address these modifiable family practices. The AAP’s Healthy Active Living for Families project created a number of resources and tools for pediatricians and families to support these discussions at the point of care. Visit About HALF to learn more.

For More Information

Institute of Medicine (IOM). 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press.

Dattilo AM, Birch Leann, Krebs NF, Lake A, Taveras EM, Saavedra JM. Need for early interventions in the prevention of pediatric overweight: A review and upcoming directions. Journal of Obesity. Volume 2012, Article ID 123023, Pages 18. doi:10.1155/2012/123023.

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American Academy of Pediatrics