Be Smart

Looks can be deceiving when it comes to a child's size. In one survey, 49 percent of parents whose kids were overweight thought they were average size. The American Academy of Pediatrics advises that all kids ages 2 and up have their body mass index (BMI) measured by their doctor at least once a year. BMI is a calculation based on height and weight that's a good indicator of excess body fat. Unfortunately, not all pediatricians check it routinely, so make sure to ask for it.

But many people miss the signs that a child (especially a boy) is too chubby. In one study, only 21 percent of the moms of overweight preschoolers knew it. As more and more kids get heavier — the average child's waist has gone up two sizes in the past 20 years — kids who are overweight increasingly look "normal" to us. An overweight child's more likely to become an overweight adult, and that in turn can lead to many health problems.

So it's up to you to be alert to the signs that your child's overweight or gaining too quickly. "Our current lifestyle is putting kids at risk for serious health problems," says pediatrician Sheila Gahagan, M.D., of the University of Michigan's Department of Pediatrics and Center for Human Growth and Development in Ann Arbor, "but we can turn it around." The hard part: Improving their lifestyle usually means changing yours, too.

That means neither obsessive eating nor quick weight-loss plans, which are especially dangerous for children, whose growing bodies require nutrients from a broad variety of foods, including healthful fats. Instead, what's needed is a return to good nutrition centered on family meals, says Naomi Neufeld, M.D., a pediatric endocrinologist and director of KidShape, a family-based pediatric weight-management program in four states.

Nursing can reduce the risk of obesity in childhood and beyond. Compounds in breast milk help regulate appetite and body fat, and babies take in only as much milk as they need. If you bottle-feed your baby — whether with formula or expressed breast milk — resist encouraging him to finish that last ounce. Your baby knows when he's had enough.

Whether you're nursing or bottle-feeding, don't automatically feed your baby every time he cries. And don't rush to start on solids. It's best to wait until 6 months — especially if your baby's a little heavy to start with. When you do start, don't overfeed him. When he turns his head away, the meal's over.

Toddlers: 1 to 3 years
Toddlerhood is a time when many parents, without realizing it, set the stage for mindless consumption of empty calories. Limit sugary drinks, including 100-percent juice (low-fat milk and water are best), and avoid eating in front of the TV. And don't pacify your antsy toddler with food. Instead, read a book together or give him an activity to do. Between meals, offer healthy snacks, such as soft, bite-size pieces of fruit and vegetables, string cheese, or low-fat yogurt.

Preschoolers: 3 to 5 years
Even though your child is growing fast, it's important to practice portion control. A good rule of thumb: Serve one tablespoon of each food being offered per year of age. A typical meal for a 3-year-old might be three tablespoons each of pasta (try whole-wheat), peas, chicken, and fruit. If your child doesn't want it all, don't push him to eat. Remember that your child's tastes change, so don't stop serving broccoli just because he rejects it once. Keep offering a variety of healthful choices at every meal.

School-age kids: 5 years and up
Find fun ways to teach your child about nutrition, like making a sticker chart to log each time he eats fruit, veggies, or other healthy foods. And for treats, continue to keep portion sizes small — try "fun-size" candy bars instead of whole ones. Cut down on sugary or fatty foods as much as possible. For instance, mix sugary cereals with healthful look-a likes.

• Don't limit your child to playing fields. Let her play indoor volleyball with a beach ball and use the sofa as a net.

• Let the games grow with your child. She loves to run a circular path around the living room? When she's ready, put down cushions for her to jump over.

• Encourage your child to show off. Your preschooler will happily count how many times she can hop on one foot — so take advantage and get her moving.

• Get in on the action. A game of tag with your preschooler is a lot more fun than 50 crunches by yourself!

Babies: 0 to 1 year
Give your baby plenty of soft, safe toys to play with, as well as an unrestricted space, such as an area rug, where he can safely roll over, push and pull up, sit, crawl, and play movement games like patty-cake with you.

Toddlers: 1 to 3 years
Experts recommend that toddlers get at least 30 minutes of structured activity each day, and one to several hours of unstructured activity. Once your child is walking, let him act on his natural desire to keep moving. Spot him as he climbs the stairs, and give him a chance every day to play outside. When it's raining, dance with him or roll around on the rug. And when it's time to look for daycare or a preschool program, look for one with a daily schedule that includes both structured games like Duck, Duck, Goose and unstructured run-around time.

Preschoolers: 3 to 5 years
By age 3, kids need an hour of structured and one to several hours of unstructured play — and shouldn't be sedentary for more than an hour at a time. You don't need to do much to get kids moving at this age: If the weather's nice, go outside, or take a nature hike with a plastic bucket, which your child can fill with found "treasures." He's also old enough to play Frisbee, hop-scotch, kickball, and other games.

School-age kids: 5 years and up
Big kids should get about an hour of moderate to vigorous activity a day. It doesn't have to be all at once — 10 or 15 minutes at a time is fine. The great thing is, your child can now share more fully in family outings such as hiking, biking, and skating. And he's old enough for organized activities, such as soccer, softball, karate, gymnastics, hip-hop dance, and ballet. But don't forget simple things, like walking to school with friends, to help him stay fit.

Sleeping Habits

To make sure your child gets all the snoozing she needs:

• Stick to regular sleep and wake-up times, even on weekends.

• Create a calming bedtime routine, like a warm bath followed by a book.

• Limit caffeinated beverages, especially before bed.

• Keep her room dark and quiet at night, which means no TV.

• Encourage her to exercise (active kids tend to sleep better) — but not right before heading to bed.

• Make sure she has enough downtime, since stress can lead to sleep problems.

Now you can start to help your child avoid the obesity trap by starting good eating, exercise habits and sleeping habits when he's a baby. But even if he's picked up some unhealthy habits, it's never too late to help him learn to control his weight. Be a good role model yourself, and set consistent rules — such as limiting sugary and fatty foods and doing fun physical activities daily.