This training module offers an overview of Let’s Move! Child Care for child care and early education providers. The module is intended for use by trainers, and may be adapted for specific needs and audiences.

For questions, please email LMCCHelp@cdc.gov.

Training Module: Let’s Move! Child Care Overview

www.HealthyKidsHealthyFuture.org

What is Let’s Move! Child Care?

One component of the First Lady’s Let’s Move! initiative to solve the obesity problem

Supports providers to adopt best practices for physical activity, screen time, foods, beverages, and breastfeeding through free resources and interactive, online tools

Recognizes providers who meet best practices

Learning Objectives

By the end of this training, you will understand:1) Basics about childhood obesity prevention and

why you have an important role

2) How participating in Let’s Move! Child Care can help you prevent obesity among children in your care

3) Where to find free tools and tips to help you meet the Let’s Move! Child Care goals and be recognized for your efforts

Basics about Obesity

Obesity

Common

Costly

SolvablePhoto source: www.obesityinamerica.org

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2010

Childhood Obesity

24% - 33% of 2 – 5 year olds are overweight or obese.

Obesity rates for young children doubled in about a 20 year period of time (1980’s – 2000).

Obese children are more likely to become obese adults.

If children are overweight, obesity in adulthood is likely to be more severe.

What Is Obesity?

How Is It Measured?

Excess body fat

Indirectly: Excess weight for height

Body mass index (BMI)Weight (kg)/height(m)2

How do you know if a child is obese?

CDC growth charts are used to determine a child’s BMI.

For children 2 and older:Obesity = BMI ≥ 95th percentile for children of the same age and sexIt can be hard to tell if a child is becoming obese just

by looking.

Knowledge Check

Children who are obese are more likely to develop:

Heart disease Diabetes Cancer Sleep Problems All of the above

Knowledge Check

Children who are obese are more likely to develop:

Heart disease Diabetes Cancer Sleep Problems All of the above

Health Consequences

Heart disease

Type 2 diabetes

Cancer

Sleep apnea and respiratory problems

Hypertension

High blood cholesterol

Stroke

Osteoarthritis

Gynecological problems

Liver and Gallbladder disease

Obesity increases the likelihood of certain diseases and health problems, such as:

Education Consequences

Children who are overweight or obese can be undernourished at the same time.

Nutrition deficiencies Impair brain development and cognitive

functioning, including learning

Education Consequences (2) Physical inactivity

Activity promotes brain development, improves sleep, builds self confidence, and reduces stress & depression

Children who are not active have more behavioral and disciplinary problems, shorter attention spans in class and do worse in school compared to active children

Screen Time Interferes with exploration, playing, interaction

with others, which promote social development Competes with being active, social interaction,

reading, and doing homework

You Play an Important Role in Preventing Obesity!

Moving Forward to Reverse the Obesity Trends

“ … we know the cure for this. This isn't like putting a man on the moon or inventing the Internet - it doesn't take some stroke of genius or feat of technology. ... Rarely in the history of this country have we encountered a problem of such magnitude and consequence that is so eminently solvable.”

Michelle ObamaFebruary 9, 2010

Video Message from First Lady Michelle Obama

[For the video, please email LMCCHelp@cdc.gov.]

Why obesity prevention in child care and early education programs? Prevention must start early.

Children spend many hours in your care.

You can provide a healthy environment for children to eat, play, and grow. 

Why obesity prevention in child care and early education programs? (2) You can help children build healthy

habits for life Food preferences and physical activity habits

develop during early childhood and continue into adulthood

You are a role model. Kids do as you do, especially when they’re young.

You are in a unique position to educate parents about healthy eating and activity

What You Can Do to Prevent Obesity

Preschool Teacher Builds Healthy Habits

[To show the video, go to: http://www.cdc.gov/CDCTV/ChildObese/index.html]

5 Let’s Move! Child Care Goals

1 Physical Activity

2 Screen Time

3 Food

4 Beverages

5 Infant Feeding

1 Physical Activity

Knowledge Check

What is the recommended amount of physical activity for toddlers in full day care?

15 - 30 min 30 - 45 min 60 - 90 min 90 - 120 min

Knowledge Check

What is the recommended amount of physical activity for toddlers in full day care?

15 - 30 min 30 - 45 min 60 - 90 min 90 - 120 min

Physical Activity Best Practices

Infants: Short supervised periods of tummy time several times each day

Toddlers & Preschoolers: Active play time every day, both indoor and outdoor Toddlers: 60 – 90 minutes or more

(for half-day programs, 30 minutes or more) Preschoolers: 120 minutes or more

(for half-day programs, 60 minutes or more)

REMINDER: Make sure that kids with special needs can

participate in activities too!

Benefits of Physical Activity

Helps children stay at a healthy weight In childhood In adulthood – physical activity habits

learned in early childhood can last a lifetime

Helps children: Develop motor skills and build their

strength, flexibility, and endurance Develop and maintain strong bones Improves social skills and brain

development Sleep better Feel confident about themselves and

their bodies Reduce their risk of feeling stressed or

depressed

Benefits of Physical Activity (2)

Children who are active tend to have fewer behavioral and disciplinary problems, do better in school, and have longer attention spans in class.

Ways to Get Kids Moving

Add physical activity into your daily routine Have children act out a story

as you read it to them. Encourage kids to move like

different animals during transitions from one activity or room to another.

Mix up the usual ‘hokey pokey’ and ‘head, shoulders, knees and toes’ with a dance party or obstacle course

Encourage working together to come up with games and activities

Keep infants active too

During tummy time: Encourage them

to see, touch, and feel what’s around them

Try putting their favorite toys just out of reachREMINDER: Always make sure infants have tummy

time when they’re awake and alert and placed on a solid surface on the floor (never on a surface that’s soft or up high like a mattress or sofa).

2 Screen

Time

Knowledge Check

How much screen time should children under 2 years be allowed?

None 20 minutes 30 minutes 40 minutes

Knowledge Check

How much screen time should children under 2 years be allowed?

None 20 minutes 30 minutes 40 minutes

Screen Time Best Practices

Infants: No screen time Toddlers: No more than 3 – 4 times per year, or

never Preschoolers:

Only for educational or physical activity purposes No more than 30 minutes per week or never, while in

your care Work with families to ensure no more than 1 - 2

hours per day

Provide screen time reduction and/or media literacy education to parents at least twice a year, e.g. special programs, newsletters, or information

sheets

Reasons for Reducing Screen Time

Gets in the way of exploring, playing, and social interaction.

As kids get older, screen time can get in the way of being active, reading, doing homework, playing with friends, and spending time with family.

Kids who spend more time watching TV are more likely to be overweight or obese.

Ways to Reduce Screen Time Keep the TV/computer out of sight

Put it in rooms not used by children Hide it with a blanket or sheet Get rid of it

Replace screen time with fun, interactive activities Turn on the radio or a CD and dance Play outside Bring kids into the kitchen and let them help

you set the table, cook, and clean up

When screen time is allowed:

Make it “quality programming” by choosing shows or computer games that are educational or get kids moving.

Track screen time with a simple scheduling sheet so you know how much screen time a child has and when they’ve reached their limit for the week.

3 Food

Knowledge Check

Do French fries, tater tots, or hash browns count as vegetables?

Yes No

Knowledge Check

Do French fries, tater tots, or hash browns count as vegetables*?

Yes No

*Referring to foods counted as vegetables within LMCC best practices, not current creditable foods for CACFP.

Food Best Practices

Toddlers and preschoolers Serve a fruit and/or a vegetable at every meal

(Juice doesn’t count as fruit, and French fries, tater tots, and hash browns don’t count as vegetables!)

Limit fried and pre-fried foods French fries, tater tots, hash browns, potato chips, frozen and breaded meats or fish to no more than once a month

Preschoolers: Serve all meals family style so that children are encouraged to serve themselves with limited help.

Benefits of Healthy Food

Helps children stay at a healthy weight

Opportunity to teach kids’ taste buds to appreciate healthy foods. Food preferences develop at an early age, even in infancy.

Ways to Promote Healthy Eating Have taste tests for

kids to try new veggies and fruits

Serve veggies with yogurt, hummus, or low-fat dressing.

Buy healthy alternatives. Many healthy options cost the same as the not-so-healthy choices (like whole wheat bread vs. white bread)

Ways to Promote Healthy Eating (2) Offer healthy alternatives in place of

fried foods INSTEAD OF fries TRY potatoes sliced and

baked INSTEAD OF potato chips TRY baked

vegetable chips INSTEAD OF chicken nuggets TRY baked

chicken

Be creative and find ways to have healthy holiday and birthday celebrations

REMINDER: Hang in there! It may take 10 to 15 tries for young children to accept a new

food.

Basics about Family Style Dining Let children serve

themselves with limited help

Talk with children about the foods they’re eating

Adults sit at the table and eat the same foods Role model healthy

eating Prevent fighting, feeding

each other, choking, etc.

Benefits of Family Style Dining Improves self-feeding skills and recognition of

hunger cues

Supports social, emotional, and motor skill development

Children learn about the food they’re eating and are more likely to enjoy and eat healthy food

Language skills improve as adults and children talk with each other

Positive role modeling

Ways to Make Family Style Dining Work

Let kids practice serving themselves first Use play food, like plastic fruits

and veggies. Use the right equipment

Use child size pitchers, tongs, and serving bowls and plates.

Put dressings and dips in child size squeeze bottles.

Be prepared for spills! Show kids you enjoy eating

healthy foods. They will follow your example!

4 Beverages

Knowledge Check

What kind of milk should children 2 years and older drink?

Whole milk 2% (reduced

fat) 1% or non-fat

(skim) milk Flavored milk

Knowledge Check

What kind of milk should children 2 years and older drink?

Whole milk 2% (reduced

fat) 1% or non-fat

(skim) milk Flavored milk

Beverages Best Practices

Water: visible and available inside and outside for self-serve

Fruit juice: Only100%; limited to no more than 4 – 6 oz. per day per child and encourage parents to support this limit

Sugary Drinks: Never (includes fruit drinks, sports drinks, sweet tea, and soda)

Milk: Serve only 1% or non-fat (skim) milk to children 2 years and older (unless otherwise directed by the child’s health provider)

REMINDER: Don’t provide water in “sippy cups” or bottles!

Benefits of Drinking Water

Keeps kids hydrated best

Reduces acid in the mouth that can cause cavities

Water instead of sugary drinks reduces the amount of calories children consume.

REMINDER: Infants less than 6 months should not be given water

Benefits of Skim or 1% Milk

Milk is packed with nutrients like calcium and vitamin D that help kids grow and build healthy bones

Skim and 1% milk have the same amount of calcium and vitamin D as whole milk, but without the extra fats. Kids over 2 no longer need those extra fats.

Ways to Promote Healthy Drinks Take water jugs and cups with you

outside. Try adding fruit slices or berries to water

for an extra fun taste! Try diluting 100% fruit juice with water to

train children’s palette to enjoy less sweetness.

Model healthy drinking by avoiding sugary drinks in front of children.

Instead of juice, serve fresh fruit, which includes important dietary fiber and is a natural source of energy.

5 Infant Feeding

Knowledge Check

How long should babies be breastfed exclusively?

3 months 4 months 5 months 6 months

Knowledge Check

How long should babies be breastfed exclusively?

3 months 4 months 5 months 6 months

REMINDER: The American Academy of Pediatrics recommends that babies should not receive formula, water, juice, non-breast-milk, or food for the first six months and nursing continue until 12 months (or longer).

Infant Feeding Best Practice

Have a private room for moms to breastfeed or pump

other than a bathroom

appropriate seating and privacy

Benefits of breastfeeding

Prevents obesity Defends against infections (keeping

infants from getting sick with things like diarrhea and ear infections)

Protects against a number of conditions—like asthma, diabetes, and sudden infant death syndrome (SIDS)

Ways to Support Breastfeeding Educate teachers and staff about the

importance of breastfeeding and how to properly handle breast milk.

Respect parents’ wishes to give breast milk, infant formula, or both.

Reassure nursing mothers. Create an ideal environment to pump or

nurse.

Participating in Let’s Move! Child Care

www.HealthyKidsHealthyFuture.org

Why Participate?

You can make a difference You can be a champion for

healthy choices You’re a role model You care You’re a partner in parenting It’s easier than you might think!

www.HealthyKidsHealthyFuture.org

1.Sign up online at www.HealthyKidsHealthyFuture.org to receive a participation certificate and resource updates

2.Take the Checklist Quiz to see how you are doing on the 5 goals

3.Build an Action Plan to reach the goals

4.Use the free online resources to help implement your action steps

5.Retake the Checklist Quiz once you meet the goals and earn the LMCC Provider Recognition Award

6.Share your success story

LMCC Steps to success

www.HealthyKidsHealthyFuture.org

Post your participation certificate to let families know the goals you’re working towards!

Updates from LMCC

New resources and website features

Online training announcements

‘How to’ tips, activity sheets, & ideas from providers like you

See where you are and make a manageable action plan to achieve the LMCC goals

Take the Checklist Quiz

Look for the ‘Take Action’ box on the homepage.

Checklist Quiz: Part 1

Answer questions to see which best practices you are meeting and which goals you need to work on

Available in English and Spanish

Build your action plan

Action Planning is an important step to help you make changes

You choose your priorities—start with whatever is going to be easiest, then build on your success

Be ready to create individual action steps

Samples are available

Checklist Quiz: Part 2

Sample Action Plan

Easy Drag & Drop!

www.HealthyKidsHealthyFuture.org

LMCC Process Snapshot

Make Action Plan

NO

Implement Steps in

PlanFree online tools,

resources, webinars, help from trainers

Take Checklist Quiz

Meet all best

practices?

Sign Up on Websit

e

CONGRATULATIONS! LMCC

Recognition AwardYES

www.HealthyKidsHealthyFuture.org

www.HealthyKidsHealthyFuture.org

Finding resources and tips

www.HealthyKidsHealthyFuture.org

Visit www.HealthyKidsHealthyFuture.org

Curriculum

Menu Planning & Recipes

Training videos

Activity Sheets

Parent Handouts

And more!

Resources

Kid-friendly recipes, menu planning guides, healthy eating tips, shopping lists, and more!

Healthy Eating

Physical Activities

Fun activity ideas, tips for incorporating physical activity into your daily routine, activity sheets, and more!

Ideas and Resources

One stop shop for nutrition and physical activity resources for all providers, including centers and family child care homes

Resources in Spanish

Resources for providers serving tribal communities

Videos

Articles from KidsHealth.org

Sample Resources

Nutrition & Physical Activity Curriculum (with DVD)

Tip Sheets

Activity sheets

eXtension Alliance for

Better Child Care Hands-on

Activities Database

Songs to get kids dancing

Resources for families

Tips for parents

Available in English and Spanish

Healthy eating and activity tips for you!

Healthy recipes

PostersBreastfeeding Resource

Kit

Nutrition and physical activity resources for tribal communities

Mini poster para niños preescolares

Recurso para

Actividades Físicas 

Free Online Trainings

One for every LMCC goal

Special topics Farm to

Preschool Using

LMCC resources

Share your Success!

For more information

Visit www.HealthyKidsHealthyFuture.org

Contact the Let’s Move! Child Care Help Desk LMCChelp@cdc.gov

Share your success stories!www.healthykidshealthyfuture.org/resources/testimonials.html

Local Resources

[insert any local resources—e.g. contact information for technical assistance like Child Care Resource & Referral Agencies, Cooperative Extension, child care health consultants; grant opportunities; nutrition and physical activity websites created by your local health department; and upcoming training opportunities]

The following slides are intended to offer trainers ideas on interactive activities that they can lead during training sessions. Use them to break up the presentation to help keep people’s attention and reinforce messages

Activity Ideas for Trainers

Build in physical activity breaksPhysical activity break ideas: Read a story with action verbs and act out the

actions as a group as you read the story. (see example in a following slide)

Sing a song that gets providers moving (see example in a following slide)

Physical activity breaks help to energize providers throughout your session so they can stay engaged! Activity breaks are especially important for longer presentations, but they are good to include for presentations of all lengths. Plus, the activities can serve as fun examples of activities they can do with their children.

Activity Break

Get on your feet for a fun activity! (that can be also be used with kids!)

Action Story New Fruits and Veggies at the Market

My Bonnie Lies Over the Ocean My Bonnie lies over the ocean,my Bonnie lies over the sea,My Bonnie lies over the ocean, O bring back my Bonnie to me.

Bring back, bring back, O bring back my Bonnie to me, to me.Bring back, bring back, O bring back my Bonnie to me.

Come up with games

1) Break providers up into groups of 3 – 5. 2) Ask them to come up with a game using

bean bags that they can play with their children.

3) Give providers 15 minutes to come up with the game.

4) Ask each group to present the game to the larger group.

This activity should be done after reviewing the physical activity slides. It encourages providers to be creative and come up with a low-cost activity to get kids moving. It also gives providers an opportunity to share their ideas and take home new activity ideas that they can implement in their programs. This is also a great way to get providers moving around the room and get their energy up!

Best Practices in Review

Pop Quiz! Can you recite all of the [insert goal area here – e.g. food] best practices

without looking at your notes?

Role play

After presenting information on action planning, have participants come up with different scenarios that may present challenges and have providers act them out. Try having a few scenarios ready prior to the session and then coming up with the rest as a group during the session.

Example scenarios: How would you respond to a parent who wants their child to have

screen time while in care? Ask for a volunteer to play the provider and one to play the parent.

How would you talk to families about packing healthy beverages for their child? Ask for a volunteer to play the provider and one to play the parent.

How would you talk with your director about incorporating more physical activity into the day? Ask for a volunteer to play the director and one to play the teacher.

This activity helps providers think about potential challenges and practice how they would overcome them.

Play Videos to Reinforce Goal Messages

Insert videos throughout the presentation to reinforce the messages on the goals

Embed the videos in your presentation so they will play on demand

Family Style Dining: http://www.youtube.com/watch?v=nj_s89ydnBs

Physical Activity: http://youtu.be/k55liTC7sGI

Screen Time: http://youtu.be/cogJkMgIjs0

Trying New Foods: http://www.sesamestreet.org/parents/topicsandactivities/toolkits/food (Available on DVD)

Take the Checklist Quiz

1) Print out the paper version of the LMCC Checklist Quiz and pass one out to each provider (For the paper version, go to http://www.healthykidshealthyfuture.org/content/hkhf/home/startearly/quiz.html or email LMCCHelp@cdc.gov)

2) Give providers 10 – 15 minutes to complete the quiz.

3) Have providers create an action plan. You may want to encourage providers to work with others who are working towards the same best practices.

4) Have providers share examples of action steps they plan to take with the larger group.

Often, providers are most excited about implementing the LMCC best practices right after they’ve learned about the importance of nutrition and physical activity and ways to promote healthy habits in their programs. Take advantage of this window of opportunity by making time for providers to take the Checklist Quiz during your session. Plus, when you’re in the room, you can help answer questions they might have about the best practices or how to make changes in their programs.

Have small group discussionsAfter taking the LMCC Checklist Quiz this activity gives providers an opportunity to identify common challenges, share ideas, and learn

from others who have already overcome these challenges.

1) Break providers up into groups of 5 – 7. 2) Ask them to talk about their current

challenges related to promoting nutrition and physical activity.

3) Give providers 20 minutes to discuss their challenges and come up with solutions.

4) Ask each group to share what they discussed with the larger group.

Identify next steps

1) At the end of the session, pass out pieces of paper or note cards and pens.

2) Encourage providers to write down 1 to 3 action steps they will take when they go back to their programs.

3) Ask for volunteers to share what they wrote with the larger group.

By identifying clear action steps, providers will be ready to make changes when they return to their programs.

We compiled some of our best ideas and tips based on our experience conducting presentations and training providers across the country. We hope these tips will be helpful to you!

Presentation Tips for Trainers

Presentation tips

To help maintain providers’ interest and focus, break up slides by playing videos or having physical activity breaks. We’ve placed videos throughout this training module at points where providers typically need breaks.

Use visuals—e.g. bring examples of low-cost physical activity props like bean bags and yoga flashcards, show 4 oz. and 6 oz. cups (it’s often hard for people to visualize these amounts), and show examples of equipment for family style dining like child size pitchers and tongs.

Bring one or more computers and set up a station where providers can sign up to participate in LMCC and explore the LMCC website. Make sure to check with the hotel ahead of time to see if you need to purchase internet access.

Presentation tips

Bring hand outs—e.g. tip sheets from the LMCC website, recipe ideas, activity tips (see ‘Ideas for Handouts’ slide).

Pass out the LMCC promotional flyer, which includes the LMCC goals, steps for participating in the initiative, and the LMCC website and contact information for help. Download the flyer in English or Spanish, at http://www.healthykidshealthyfuture.org/content/hkhf/home/resources.html (see the ‘promotional materials’ section).

Give away ‘participation prizes’—e.g. if a provider helps you lead an activity, give him/her a prize like a CD with songs for kids or a printed version of the Head Start Body Start Activity Calendar, a recipe book, or other resources you find on the LMCC website. Prizes can incentivize providers to actively participate!

Presentation tips

Encourage providers to eat healthy and drink water during the session. If you bring snacks, make sure they’re healthy! If possible, have pitchers of water and cups available.

At the end of the session, ask providers to evaluate the session by filling out a short survey on what they found to be most/least useful and what they plan to do as a result of the session. You can use these evaluations to show the value of the training and to help you make improvements.

Ideas for Handouts

Water & Juice Tip Sheet: http://nrckids.org/TipSheet/JuiceTipSheet.pdf Family-style dining tip sheet: http://

www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/resources/familydiningtips.pdf

Healthy Eats from A to Z: http://www.kcfb.info/chicka/ChickaChicka_HealthyEats.pdf

Healthy Menu Planning: http://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/naccrra/newnaccrra/menuplan.pdf

Making the Most of Meal Times: http://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/naccrra/newnaccrra/makingmealtime.pdf

Healthy Moves from A to Z: http://www.kcfb.info/chicka/ChickaChicka_HealthyMoves.pdf

Get Moving Today! Activity Calendar: http://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/kidshealthsheets/FinalENGLCalendarFULL.pdf

Non-Competitive and Active Games for Preschoolers: http://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/naccrra/newnaccrra/noncomgames.pdf

We are always excited to learn about local efforts to train providers on LMCC. Let us know about your training activities by emailing us at LMCCHelp@cdc.gov. You can also share your story by filling out a short online form at http://www.healthykidshealthyfuture.org/content/hkhf/home/resources/success.html. Your story may be featured on the LMCC website.

Thank you for all you do to support children’s health! We look forward to hearing from you.

Share Your Training Success Story