State child care regulations failing to protect children's health, study reveals

September 18, 2012

(Medical Xpress)—Child care center regulations in most states don't uphold the health standards set by the nation's leading pediatricians' group, missing opportunities to prevent tooth decay and obesity among millions of the nation's young children, suggests a recent study.

On average, state regulations cover only a third of the oral health standards and half of the for early care and education programs developed by the American Academy of Pediatrics in collaboration with the American Public Health Association and the National Resource Center for Health and Safety in Child Care and Early Education.

"Considering the rising rates of both obesity and among preschool children, child care can be an important point of intervention in today's society," said the study's lead author, Juhee Kim. "We hope that the findings will prompt child care providers to develop and implement comprehensive feeding and oral health care policies."

With nearly 75 percent of U.S. children experiencing regular non-parental day care, federal and state officials have significant opportunities to help safeguard children's health through program regulations and policy, according to the researchers.

The standards used for the study were outlined in the 2002 edition of the report "Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs." Kim's research team compared the standards against regulations for the 50 and the District of Columbia that were in force from February-April 2010, according to a database maintained by the National Resource Center.

The study's focus was prevention of early childhood caries, a virulent form of that is on the rise among the nation's youngest children, according to the .

The national standards for nutrition – which address infant breast-feeding, meal and snack patterns and children's intake of fruits, vegetables and sugar-sweetened beverages, among other issues – also have implications for preventing childhood obesity as well as dental caries.

The third and most recent edition of the standards was issued in July 2010 and contained recommendations for obesity prevention, such as specifying the type and frequency of physical activity for children by age group and using "teachable moments" and learning experiences on appropriate portion sizes.

Of the eight national standards set for children's oral health, the mean number covered by state regulations was 2.6, the researchers found.

Seven states – Arkansas, Hawaii, Idaho, Maryland, Michigan, Montana and Rhode Island – included none of the oral health guidelines in their child care regulations. Illinois and West Virginia covered the highest number of oral health standards, with six each.

Children's having a toothbrush in child care settings was mentioned in 39 states' regulations, the highest response for any of the topics.

However, only 10 states had policies pertaining to the frequency of children's teeth brushing, but eight of them pertained only to children that were in care at night.

Although the national standards recommend that children undergo oral screenings upon entering or at some time during care, only four states – Massachusetts, Nevada, Pennsylvania and Virginia – and Washington, D.C., mentioned or implied oral screenings.

States did somewhat better with adhering to the nutritional , with 30 states requiring that menus at child care centers include fruits and vegetables, although the amounts and types varied. Nearly all of the states had regulations that addressed the frequency of children's meals and snacks, which varied from two to four hours, depending upon the number of hours that children were in care.

However, eating that frequently without proper oral hygiene contributes to the development of dental caries, the researchers pointed out.

Sugar-sweetened beverages were prohibited by seven states – Delaware, Georgia, Indiana, Mississippi, New Mexico, North Carolina and Oregon – and Georgia, Mississippi and North Carolina further recommended that non-nutritional drinks be limited to special occasions.

While most states (39) prohibited propping baby bottles, slightly fewer – 34 states – prohibited children's carrying or sleeping with bottles, practices that also have been linked to dental cavities.

Although 38 states had regulations supportive of breast-feeding, only Delaware, Mississippi and Washington, D.C., mandated that mothers be allowed to breast-feed at child care centers.

The study, which was funded in part by a National Research Foundation grant from the Korean government, appeared recently in the journal Pediatric Dentistry.

Explore further: Child-care facilities can do more to promote healthy eating and physical activity among preschoolers

Related Stories

Child-care facilities can do more to promote healthy eating and physical activity among preschoolers

August 26, 2011
Eating and physical activity habits for a lifetime can develop at an early age. As the use of preschool child care increases and the prevalence of childhood obesity is at an all-time high, the opportunity to positively impact ...

Programs may prevent tooth decay in tots

June 15, 2011
A toddler’s tiny teeth are destined to fall out in later years as their permanent pearly whites grow in. But for some children, especially those from low-income families, cavities and poor oral health lead to complicated ...

Tiny teeth in tatters

October 27, 2011
The tiny teeth of some of our toddlers are rotting and dental researchers at the University of Sydney are poised to start the second phase of a long-term study to find out why.

Mom's emotional health, education level linked to teen oral health

August 22, 2012
(Medical Xpress) -- A mother's emotional health and education level during her child's earliest years influence oral health at age 14, according to a new study from Case Western Reserve University's School of Dental Medicine.

Recommended for you

Higher blood sugar in early pregnancy raises baby's heart-defect risk

December 15, 2017
Higher blood sugar early in pregnancy raises the baby's risk of a congenital heart defect, even among mothers who do not have diabetes, according to a study led by researchers at the Stanford University School of Medicine.

Injuries from window blinds send two children to the emergency department every day

December 11, 2017
Most homes have them. They help keep our rooms warm or cold and even add a pop of color to tie the décor together. But window blinds can cause serious injuries or even death to young children. A new study from the Center ...

Blood flow altered in brains of preterm newborns vs. full-term infants

December 4, 2017
Cerebral blood flow (CBF) of key regions of newborns' brains is altered in very premature infants and may provide an early warning sign of disturbed brain maturation well before such injury is visible on conventional imaging, ...

HPV vaccine is effective, safe 10 years after it's given

November 29, 2017
A decade of data on hundreds of boys and girls who received the HPV vaccine indicates the vaccine is safe and effective long term in protecting against the most virulent strains of the virus, researchers report.

Antibiotics administered during labor delay healthy gut bacteria in babies

November 28, 2017
Antibiotics administered during labour for Group B Streptococcus (GBS) affect the development of gut bacteria in babies, according to a study from McMaster University.

Stress in pregnancy linked to changes in infant's nervous system, less smiling, less resilience

November 23, 2017
Maternal stress during the second trimester of pregnancy may influence the nervous system of the developing child, both before and after birth, and may have subtle effects on temperament, resulting in less smiling and engagement, ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

freethinking
1 / 5 (1) Sep 18, 2012
Yup Progressives to the rescue. More regulation and oversight of children, can't trust parents.

Just a question. In the last 30 years there are more regulations and oversight of raising children, more feeding of children at schools, so IF government and its regulations and oversight is so good, we should expect children to be in better shape than 30 years ago, right? Since this obviously isn't the case, only a Progressive would be stupid enough to say, we need more failed programs.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.