This study examined the leadership approach to child health and wellbeing within the early-years sector; it drew upon the evidence from thirty-two practitioners and ten nursery managers. Practitioners evidenced the challenges in recognising the signs and symptoms of low wellbeing and in monitoring progress. A constructivist paradigm enabled qualitative data to be collected from an interactive questionnaire and three focus groups of nursery managers. Analysis was supported by two wellbeing models: the PERMA model (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) and the SHANARRI wheel (Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible, Included). The findings accentuated the lack of confidence of practitioners in identifying the precursors of health and wellbeing, and their ability to monitor the progress to support children. In conclusion, a clear definition of health and wellbeing should be adopted by managers; their leadership is vital to support the training of practitioners sharing their knowledge and experience to less-qualified staff. The main issues to transpire highlighted that clear mandatory guidance should be available for early-years practitioners, and the creation of a bespoke early-years model to measure child health and wellbeing.