State and Regional Variation in Regulations Related to Feeding Infants in Child Care

Benjamin, Sara E.; Taveras, Elsie M.; Cradock, Angie L.; Walker, Evan J.; Slining, Meghan M.; Gillman, Matthew W.

doi:10.1542/peds.2008-3668

Cited by 28 publications

(30 citation statements)

References 19 publications

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“…In our previous study examining state child care regulations related to healthy infant feeding practices, we did not observe geographic differences in the number of state regulations for centers or homes. 37 Additionally, the number of state regulations was not correlated with the year of last update, but in that study we were not comparing regulations to recently released recommendations. 37 In the current study, we found that states that had updated their regulations after the IOM recommendations were released had more regulations consistent with the recommendations for homes, but not for centers.…”

Section: Overviewmentioning

confidence: 97%

“…37 Additionally, the number of state regulations was not correlated with the year of last update, but in that study we were not comparing regulations to recently released recommendations. 37 In the current study, we found that states that had updated their regulations after the IOM recommendations were released had more regulations consistent with the recommendations for homes, but not for centers. This suggests that the IOM recommendations may have prompted new regulations, although we were not able to assess the extent to which the IOM report influenced policy decisions within states and therefore cannot draw any firm conclusions.…”

Section: Overviewmentioning

confidence: 97%

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Regulations to Promote Healthy Sleep Practices in Child Care

2014

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WHAT'S KNOWN ON THIS SUBJECT: Previous studies have examined state regulations for child care facilities and found substantial variation among states. None of these studies examined regulations related to healthy sleep practices, which is an important and often overlooked intervention target for obesity prevention. WHAT THIS STUDY ADDS:We reviewed state regulations related to healthy sleep in child care and compared them to recent national recommendations put forth by the Institute of Medicine. We found that many states lacked regulations, highlighting an important and timely opportunity for improvement.abstract OBJECTIVES: The purpose of this study was to assess state licensing and administrative regulations promoting healthy sleep practices in child care and to compare these regulations to national recommendations. METHODS:We reviewed regulations related to healthy sleep practices for all states and territories for both child care centers (centers) and family child care homes (homes). We compared regulations with Institute of Medicine recommendations to promote sleep in child care, including (1) create environments that ensure restful sleep; (2) encourage sleeppromoting behaviors and practices; (3) encourage practices that promote child self-regulation of sleep; and (4) seek consultation yearly from a sleep expert. We used Cochran-Mantel-Haenszel trend tests to assess associations between geographic region and number of regulations consistent with the recommendations. RESULTS:The mean number of regulations for states was 0.9 for centers and 0.8 for homes out of a possible 4.0. For centers, no state had regulations for all 4 recommendations; 11 states had regulations for 2 of the 4 recommendations. For homes, 9 states had regulations for 2 of the recommendations. States in the Northeast had the greatest mean number of regulations for centers (1.2) and homes (1.1), and states in the South had the fewest (0.7 and 0.7, respectively); these geographic differences were significant for centers (P = .03) but not homes (P = .14).CONCLUSIONS: More states in the Northeast had regulations consistent with the Institute of Medicine sleep recommendations, but overall few states had regulations consistent with the recommendations.

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Section: Overviewmentioning

confidence: 97%

Section: Overviewmentioning

confidence: 97%

Regulations to Promote Healthy Sleep Practices in Child Care

2014

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“…Regulations for licensed FCCHs are different, and in many cases less stringent, than those for child care centers. 10 In fact, time spent in FCCH settings during infancy has been shown to be associated with increased BMI z-scores at 3 years of age, whereas time spent in child care centers has not. 11 In Rhode Island (RI), 28% of children are cared for in FCCHs, 9 with at least 40% of the RI providers being Hispanic.…”

Section: Introductionmentioning

confidence: 99%

Nutrition and Physical Activity Environments of Home-Based Child Care: What Hispanic Providers Have to Say

et al. 2015

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Background: It is important to understand the perceptions and beliefs of family child care providers (FCCPs) regarding which factors influence children's physical activity (PA), screen-time (ST), and dietary behaviors in order to develop and implement appropriate obesity prevention interventions. The aim of this qualitative study was to explore the aforementioned perceptions and beliefs of FCCPs in Rhode Island.Methods: Four focus groups (n = 30) were held with FCCPs. Providers were female, Hispanic, and Spanish speaking. Providers were asked about different aspects of feeding, PA, and ST behaviors. Themes were coded using NVivo10 (QSR International Pty Ltd, Doncaster, Victoria, Australia). Content analysis was used to analyze final themes.Results: Providers understood the importance of providing opportunities for healthy eating and PA for the children they cared for, but there was room for improvement, especially with regard to certain feeding and ST practices. Several barriers were evident, including the lack of physical infrastructure for PA, cultural beliefs and practices related to child feeding, and difficulties working with parents to provide consistent messages across environments.Conclusions: Given that FCCPs are aware of the importance of healthy eating and PA, there is a need to address the specific barriers they face, and operationalize some of their knowledge into practical everyday actions. This formative work will inform the development of a culturally relevant, multicomponent intervention for ethnically diverse FCCPs to improve the food and PA environments of their homes, which should, in turn, improve the dietary, PA, and ST behaviors of the 2-to 5-year-old children they care for.

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“…Clark et al (67) determined that providers need more than training on best practice, particularly relating to infant feeding; they also need information on how and why they should comply with standards, and while enforcement may be one way to encourage childcare providers to follow child-care regulations, relative infrequency of site visits may prevent this from being the most effective method to improve feeding practices in child-care centres; instead it has been suggested that provision of training and professional development opportunities or compensation (suggestions for which were not outlined by the authors) may be better strategies to encourage best practice (54) .…”

Section: Definition Of Pre-school Child-carementioning

confidence: 99%

Healthy incentive scheme in the Irish full-day-care pre-school setting

Molloy

Kearney²,

Hayes³

et al. 2013

Proc. Nutr. Soc.

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A pre-school offering a full-day-care service provides for children aged 0-5 years for more than 4 h/d. Researchers have called for studies that will provide an understanding of nutrition and physical activity practices in this setting. Obesity prevention in pre-schools, through the development of healthy associations with food and health-related practices, has been advocated. While guidelines for the promotion of best nutrition and health-related practice in the early years' setting exist in a number of jurisdictions, associated regulations have been noted to be poor, with the environment of the child-care facility mainly evaluated for safety. Much cross-sectional research outlines poor nutrition and physical activity practice in this setting. However, there are few published environmental and policy-level interventions targeting the child-care provider with, to our knowledge, no evidence of such interventions in Ireland. The aim of the present paper is to review international guidelines and recommendations relating to health promotion best practice in the pre-school setting: service and resource provision; food service and food availability; and the role and involvement of parents in pre-schools. Intervention programmes and assessment tools available to measure such practice are outlined; and insight is provided into an intervention scheme, formulated from available best practice, that was introduced into the Irish full-daycare pre-school setting.

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State and Regional Variation in Regulations Related to Feeding Infants in Child Care

Cited by 28 publications

References 19 publications

Regulations to Promote Healthy Sleep Practices in Child Care

Regulations to Promote Healthy Sleep Practices in Child Care

Nutrition and Physical Activity Environments of Home-Based Child Care: What Hispanic Providers Have to Say

Healthy incentive scheme in the Irish full-day-care pre-school setting

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