Preventing Childhood Obesity

Promoting the Power of Play

By: Nancy Trout, MD, MPH

As a component of the Kohl’s Start Childhood Off Right (SCOR) program, we include playing with young infants and toddlers and encouraging physical activity as part of a comprehensive obesity prevention strategy. Coupled with breastfeeding promotion and the healthy introduction of complementary foods and beverages, movement and play for young children are essential for optimal growth. Infants older than 2 months of age should have daily tummy time and object play for sensorimotor exploration.  Toddlers older than 1 year should have at least 60 minutes of unstructured play in a safe environment. Developing foundational motor skills and establishing an active lifestyle are an essential component in preventing children from becoming overweight or obese.

However, the benefits of play go far beyond healthy growth. Recently, the American Academy of Pediatrics (AAP) issued a clinical report about the role of play in enhancing development in young children. Play with parents and peers has been shown not only to build safe, stable and nurturing relationships with caregivers, but it also enhances brain development and promotes social-emotional, cognitive, language, and self-regulation skills.

Recent research has reinforced the critical importance of play in building not only essential social skills, but executive functioning skills as well. In the recent societal trajectory toward academic readiness, pre-schools and elementary schools have veered away from unstructured playful learning and toward more structured pre-literacy and pre-math activities. This academic focus not only eliminates the opportunity for children to burn calories while running and playing, it also prevents them from building fundamental social skills such as problem solving, negotiation, collaboration, and creativity. Recess and outdoor play also provides an opportunity for children of diverse backgrounds to interact and develop friendships, and they need to remain an integral part of a child’s school day.

Children also need play time at home, but with more parents working full time or having multiple jobs, and with fewer safe places to play outside, playtime for young children has been eroded. Both parents and children have also lost significant playtime to digital distractions including cell phones, tablets, computers, televisions, and video games.  Electronic “learning toys” are marketed to parents as supportive of brain development when in reality real-time social interactions such as reading books and engaging children with toys such as blocks, balls, puzzles, or crayons are superior to digital toys. For children with special needs, play spaces that include accessible “boundless playgrounds” have opened unique play opportunities for them. Parents and children engaging in play also create safe, nurturing relationships that help children develop a sense of security. Such relationships also provide a buffer against stress and help to promote resilience. These parent-child relationships can contribute to the protective factors that protect children against adverse childhood events and toxic stress.

The AAP recognizes in its clinical report that play will be fundamentally important for skill development and learning in the 21st century; the problem solving, collaboration and creativity that play stimulates will be more compatible with modern teaching through innovation, application and transfer. The AAP suggests the following for pediatricians to advocate for and help promote play:

  • Encourage parents to observe and respond to non-verbal behavior of infants in the first few months of life
  • Write prescriptions for “play” at well-child visits, and distribute them with Reach Out and Read books
  • Advocate for the promotion and protection of children’s unstructured play time at home and at school
  • Encourage pre-school educators to focus on playful rather than didactic learning to nurture social-emotional and executive functioning skills
  • Protect time for recess and physical activity in all schools
  • Emphasize the importance of playful learning to educational administrators, policymakers, legislators, parents, and the public at large

Parents, caregivers, and teachers all have an essential role to play in promoting active and free play for young children. The benefits go beyond encouraging physical activity and preventing obesity and its associated co-morbidities. Play exercises both the body and the mind of a child.

Nancy Trout, MD, MPH is co-director of Kohl’s Start Childhood Off Right, which is an initiative of Connecticut Children’s Office for Community Child Health.

Read additional blogs from Dr. Nancy Trout here.

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