One year after passage of the Healthy, Hunger-Free Kids Act—one of the most significant investments in child nutrition in 15 years— the Bipartisan Policy Center’s (BPC) Nutrition and Physical Activity Initiative convened a roundtable of experts last week to examine policies on early childhood health. The discussion was part of the Initiative’s year-long effort to enhance the physical activity and nutritional opportunities for all Americans by engaging key experts, policymakers and stakeholders from around the country to identify opportunities for collaborative action.
Research is clear: early eating patterns and long-term health are inextricably linked. What happens in the womb to a child’s second birthday can have lasting impacts on an individual’s food choices over a lifetime. So how effective are our federal feeding programs in supporting the goals of nutritious first foods? How clear are our messages to parents about what kids should be eating and at what age? How can we provide healthy choices in the environments that touch kids the most, such as hospitals, childcare settings and the workplace?
Under Secretary of USDA Food, Nutrition and Consumer Services (FNS), Kevin Concannon, kicked off the conversation with an overview of USDA’s programs and the impact the Healthy, Hunger-Free Kids Act will have on school lunches and competitive foods. Doug Greenaway, President of the National WIC Association, focused on WIC as a preventive public health strategy, which helps reduce public expenditure on illnesses often linked to poor nutrition. Loren Bell, with the Altarum Institute, noted how critical nutrition education is to these programs’ effectiveness; he reported that surveyed beneficiaries in fact value nutrition education more than the food vouchers themselves. However, as Bell explained, federal feeding programs are not always translated well at the local levels and there are often perceived—though not necessarily real— barriers to coordinating WIC and SNAP education and messaging. He proposed breaking down this categorical approach in order to improve implementation and outcomes. Jim Weill, with the Food Research and Action Center (FRAC), also focused on the importance of messaging and access. He explained that while 90% of eligible pregnant women and infants are enrolled in WIC, participation rates drop once children reach their first birthday; only 60% of those eligible in the 1-3 age range utilize the program. Consensus emerged that not only are people unaware of the programs out there, but the information is inconsistent and confusing; while the programs are different, the people using them are the same. Consumers, who likely interact with more than one federal program at a time, need one set of straightforward guidelines in a concise, consumer-friendly format.
Medical professionals, like Dr. Frank Greer, former Nutrition Chair of the American Academy of Pediatrics (AAP), agreed that there is little to no official guidance for health care providers regarding nutrition recommendations for infants and toddlers. Additionally, attendees pointed out that parents need more than general food group guidance; health providers should be equipped to offer specific food and meal suggestions. Further, the group agreed on the need for dietary guidelines for children 0 to 2, something the Institute of Medicine (IOM) has recommended and the American Academy of Pediatrics, the American Dietetic Association and the CDC have all considered.
Once a child is born, both mom and baby are surrounded by environments that can test their ability to make the healthiest choices. Breastfeeding, for example, is recognized as the most nutritious option for infants, and infant formula the second option for those who cannot or choose not to breastfeed for various reasons. A study published in the AAP journal Pediatrics in early 2010 found that the United States could save $13 billion/yr and prevent nearly 1,000 infant deaths if 90% of women breastfed exclusively for the first six months of a child’s life.
Our second panel focused on various efforts—across multiple settings—to create an “informed choice” for new mothers, and ensure that those who want to breastfeed are provided the institutional infrastructure and societal support to stick with that choice. Dr. Sandy Stenmark described Kaiser Permanente’s new baby-friendly hospital initiative, which will maximize baby-mother time and help support exclusive breastfeeding in their 29 maternity hospitals. Cathy Carothers, with Every Mother Inc., worked with HHS to create the “Business Case for Breastfeeding” initiative, underscoring the benefits that businesses accrue by providing lactation support for new moms. Such benefits include lower health care costs, increased retention rates and decreased absenteeism.
Childcare settings are another critical frontier where young children spend much of their time. Debbie Chang, with Nemours, discussed their work in Delaware to improve childcare standards statewide. Nemours previously worked with the CDC in developing the Let’s Move Childcare guidelines and was successful in integrating these guidelines into the Delaware childcare licensing standards. They then worked with local providers to implement the new policies, such as providing sample menus and activity ideas.
Perhaps Dr. Jose Saavedra summed it up best: “When we’re talking about kids, healthy growth is synonymous with obesity prevention.” A conversation about high obesity rates and overwhelming health care costs would be incomplete without addressing the importance of setting nutritional patterns early, and tackling the problem before it begins. After all, it is always easier to establish and maintain a healthy pattern from the start than break an unhealthy one in the future.
- Increasing Physical Activity for all Americans: Reframing the “PE Debate”, December 22, 2011
- From Community Commons to the Federal Health Data Initiative, Power of Sharing on Display, November 10, 2011
- The Time is Now, October 27, 2011