Summary: To be effective, any campaign against childhood obesity must include intervention strategies to combat obesity in preschool children, say researchers at the University of California San Francisco in a report published in the New England Journal of Medicine.

When childhood obesity is in the news, it’s often discussed in tandem with changes needed to school lunch programs. First Lady Michelle Obama’s Let’s Move campaign focuses a lot of attention on making school lunches healthier. A group of retired military veterans recently took up the school lunch cause, as well, because they have found many children graduating high school are too fat to qualify for military service. TV chef Jamie Oliver’s Food Revolution series focused on the issue, as well.

They’re not wrong. School lunches must be made healthier.

But to be effective, any campaign against childhood obesity must also address the needs of preschoolers, say researchers at the University of California San Francisco in a report published in the New England Journal of Medicine. The report was written by Dr. Janet M. Wojcicki and Dr. Melvin B. Heyman.

By the age of two, about one-third of all children in the U.S. are overweight or obese. This is not cute childhood chubbiness; it’s excess weight that causes real harm to their little bodies. Dr. Wojcicki and Dr. Heyman discovered markers in three-year-olds that have been linked to heart disease later in life.

What Parents Can Do for Infants to Prevent an Overweight Toddlers

First, mom should not smoke while she’s pregnant, period. Ironically, although smoking is linked to low birth weight in babies, the bad habit also influences the body’s ability to regulate weight later in life. So an underweight infant can become an overweight toddler.

Second, mothers should follow their doctors’ recommendations when it comes to breast feeding. Shorter-than-recommended breastfeeding has been linked to childhood obesity, as well as many other health concerns.

Third, parents should establish a routine that allows the baby to get plenty of sleep.  Lack of sleep also hurts the body’s ability to regulate weight. This is true from infancy through adulthood.

Whenever possible, an infant should be allowed to sleep in quiet surroundings. In other words, parents should not rely on the fact that their baby is sleeping in the car or at the ball game and say that the baby gets plenty of sleep. At loud sounds, deep sleep is frequently interrupted, even if the baby’s eyes don’t completely open. Deep, uninterrupted sleep is the goal.

What Parents Can Do to Encourage Healthy Habits Toddlers

Parents of small children should turn off the TV and the computer until after the children are in bed. Even if the children aren’t watching the TV or playing on the computer, these machines deprive the child of the parent’s attention. Parents need to make a commitment to unplug from the world for at least a couple of hours each evening.

Instead of mindlessly watching TV or chatting online with their friends, parents can play with their children. Play is exercise, and this activity can help a child to maintain a healthy weight. This time together will also cement the bond between parent and child, in addition to helping the child develop great social skills.

Another step parents can take is to abolish unhealthy snacks from the house. These snacks are hard for adults to resist, impossible for toddlers. If, instead of stocking the pantry with potato chips and sugary cereal, parents only kept on hand fruit, vegetables, cheese, and other healthy snacks, children wouldn’t have the option to fill their bodies with junk.

It is undoubtedly true that school lunches must be made healthier. However, the problem of childhood obesity is evident long before children reach school age. That means that parents must take charge of their child’s diet right from the start.