health care providers and acting on feedback regarding a child’s health are usually the responsibility of parents and families.

The committee’s task was to focus on policies that would promote and support obesity prevention among young children. The committee’s recommendations target policies that influence the programs, institutions, settings, and environments that shape children’s activities and behaviors. By definition, these policies are likely to be developed and implemented by individuals and institutions outside of the home setting. Thus the recommendations in this report target those who support parents and families in taking care of young children and those who can play a role in improving young children’s environments outside of the home. These include state and local regulators of child care, child care providers, health care providers, and directors of federal and local child care and nutrition programs, as well as members of the broader community that influence the environments of young children. These policies can be an important part of the coordination of care and consistent messages about child health that are critical to success in helping families raise healthy children.

All young children share the need for healthy food, optimum physical activity, sufficient sleep, health care providers who monitor their growth for healthy patterns and advise and assist their parents in following through, and protection from the negative influences of too much sedentary behavior and marketing of unhealthy foods and beverages to children. Nonetheless, in developing obesity prevention recommendations and implementation strategies that will be effective for young children and their families, the committee recognized the potential impact of negative social and economic factors in some communities that can act as barriers to a recommendation’s success. The committee therefore attempted to formulate recommendations to caregivers and policy makers that would be universal with respect to the optimal health of young children but also feasible through creative adaptation in many different settings with families at all socioeconomic levels.

CONTEXT FOR THE COMMITTEE’S RECOMMENDATIONS

This report and the committee’s recommendations address the assessment of obesity risk through growth monitoring, as well as key factors that influence obesity risk in young children—physical activity, healthy eating, marketing and screen time, and sleep. Although the committee’s charge was to focus on children from birth to age 5, the report also includes a discussion of prenatal influences to high-



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