Purpose: Early childhood settings play an essential role in providing young children with nutritious food while in care, and can encourage the development of healthy eating behaviours. In Australia, Family Day Care (FDC) is a form of childcare where education and care are provided for up to four children below school age and an additional three school-aged children, in a home environment. Children who attend FDC receive education and care from educators who operate from their own homes. FDC services must meet the National Quality Framework and the Early Years Learning Framework. In addition, there are the Get Up & Grow healthy eating and physical activity guidelines for young children that can help guide health policies and practices in FDC services. This study examined the nutrition and physical activity practices of FDC educators in New South Wales (NSW), Australia against the prevailing policy frameworks.

Methods: FDC educators from across NSW participated in an online survey from July 2020 to June 2021. Information regarding food provision, children’s eating environment, feeding practices, physical activity, outdoor playtime, outdoor play environment, screen time, information to families, infant physical activity, breastfeeding environment, breastfeeding support practices, and educator professional development and education were collected.

Results: There were 186 complete responses out of 295 educators who participated (63% completion rate). With nutrition practices, most educators never switched on televisions or videos during mealtimes (86%); however less than half (47%) role modelled eating healthy foods at every meal and snack time. With physical activity practices, almost half (41%) did not provide recommended time for children’s physical activity, and over one-third (36%) did not lead daily planned lessons focused on building gross motor skills. Approximately one-quarter (26%) of educators had never completed professional development on physical activity and almost one-third (32%) had never completed professional development on infant feeding and nutrition.

Conclusion: Current nutrition and physical activity practices in FDC are suboptimal. This study highlighted priority areas for improvement where training can be provided.

Purpose: To assess the feeding, physical activity (PA) and screen-time (ST) environments for infants and toddlers in childcare centers and family childcare homes (FCCHs) and to explore differences by childcare type.



Methods: Centers (n=21) and FCCH(n=20) participated in observations using a modified version for infants and toddlers of the Environment and Policy Assessment and Observation tool. Provider behaviors and environments were separated into recommended and non-recommend practices in accordance with national guidance. Chi-square analysis and Fisher’s exact test (for sample sizes less than 5) were used to analyze differences by site type for categorical variables, while t-tests were used for continuous variables with p-value of less than 0.05 considered significant.



Results: Many similarities were seen between childcare, however centers used more recommended best-practices vs. FCCHs. For example, for infants in centers we observed more enthusiastically role modeling of healthy food (58 v. 14%, p=.032), praising infants for eating healthy foods (92 v. 14%, p<.001), sitting with infants during a meal (92 v. 43%, p=.002), talking with infants about foods they were eating (100 v. 43%, p=.002), encouraging (not forcing) infants to try new foods (83 v. 43%, p=0.048 ) and talking about feelings of hunger and fullness (100 v. 18%, p<.001). Differences in negative nutrition practices (e.g., avoid spoon feeding, bottle propping and encouraging eating unhealthy foods) were mixed between types of childcare. Toddlers in centers spent more time playing at higher activity levels than those in FCCHs (61 vs. 13 minutes, p<.0.001). ST was observed in FCCH but not in centers.

Conclusions: Differences observed between childcare site types may indicate how they differentially influence infant and toddler feeding, PA and ST behaviors, which may influence obesity risk. Future research should further examine these feeding and activity practices in a larger sample of childcare centers and FCCHs to better inform interventions and policies.

Purpose: Drinking water supports child health and is a healthy, low-cost alternative to sugar sweetened beverages (SSB). Water and SSB access in childcare could play an important role in child beverage intake and health. Little research has been done in family childcare homes (FCCH), which may be higher risk settings. Water may not be accessible, or commonly offered to children in FCCH, so feasible, acceptable interventions to increase drinking water access, availability and intake are needed. The Drink Well project is a mixed methods study to better understand how to increase water availability/accessibility in FCCH and improve young children's beverage intake.

Methods: We are conducting focus groups with 36 FCCH providers (FCCPs) to determine barriers and strategies to improve water availability/accessibility and children’s intake. Then, we will conduct an intervention pilot of environmental approaches to increase water availability/accessibility in the FCCH (e.g. providing water bottles, water stations, water filters, water testing/safety strategies, technical assistance, etc.) with 40 FCCP (50% Latina) operating FCCH in low income neighbourhoods in RI, MA & CT that care for children aged 6-60 months. Pre and post-surveys will assess feasibility, acceptability and efficacy of these approaches.

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Results: The study is ongoing. Focus group and baseline surveys will be completed by May 2021. Focus group data will include: a). barriers and facilitators to providing water to children in FCCH and getting them to drink it; b). potential strategies to improve water availability/accessibility and children’s intake. Baseline survey data will include: water source at FCCH, how often drinking water, milk, juice and SSB are provided to children with meals or snacks, how water is made available to children indoors and outside, availability of self-serve water, types of water served to children, factors/facilitators influencing water provision, attitudes about and challenges to offering water and to children drinking water, equipment for serving water; knowledge about national beverage guidelines and children’s water needs, etc.

Conclusion: The Drink Well project addresses important research gaps related to beverage access and intake in FCCH, and can inform future research & policy to impact low-income/ethnic minority children at highest risk for poor diet & weight-related health disparities.