viders (McLearn et al., 1998), except perhaps their daily child care provider. They seek advice on feeding, sleep, activity, and other aspects of early childhood behavior from health care providers, which creates the opportunity to inform parents about a range of factors that impact excess weight gain in the early years of life.
Well-child visits are standard visits at which the health care provider assesses and monitors the child’s health and growth. Usually eight visits occur at set intervals throughout the first 2 years of a child’s life. During these visits, children often are measured for length and weight, and this information is plotted on growth charts. This measurement should occur at every well-child visit. And while emphasis has historically been placed on identifying undernutrition or a lack of growth, equal attention needs to be given to excess weight-for-length, which is the measure of overweight in the first 2 years of life. After 2 years of age, children routinely visit health care providers for continual assessment of their growth. Although height and weight are almost always recorded during health maintenance visits, BMI calculations after age 2 are performed less consistently (Klein et al., 2010). To assess weight gain accurately, health care providers should consistently calculate BMI values and plot them on CDC’s gender-specific BMI-for-age charts.
In addition to monitoring the child’s growth, health care providers are in a position to observe and ask about the family environment. Observations of parental weight, discussions of childhood activities and family eating patterns, and clinical assessments of weight-for-length or -height can provide valuable information on the child’s health and the potential risk for later obesity.
Health care professionals and pediatricians are best positioned to identify excess weight in young children. The interaction between parents and health care providers gives parents an opportunity to become aware of their child’s excess weight early on to allow time for intervention and prevention.
Misperceptions of Excess Weight
Because parents and other caregivers have complete control over their young children’s food intake, it is important that parents understand the growth patterns and the significance of excessive weight gain during the first few years of life. However, studies show that many parents in fact do not understand the consequences of or are not concerned about early overweight or obesity in their children. In focus groups conducted with WIC mothers, some mothers expressed the belief that it was healthy for their babies to be overweight (Baughcum et al., 1998). The overweight mothers in the focus groups believed that their children were overweight because they were genetically prone to be so; therefore, the