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Is childcare associated with the risk of overweight and obesity in the early years? Findings from the UK Millennium Cohort Study



A recent assessment of childcare in OECD (Organisation for Economic Co-operation and Development) countries highlighted the potential for childcare to widen inequalities. Although childcare offers a potential setting for obesity prevention, little research has analysed the association between childcare and overweight, particularly in different socio-economic groups.


Our primary objective was to explore the association between childcare and overweight (including obesity), both overall and by socio-economic background, in a contemporary UK cohort of children at age 3 years (N=12 354). Our secondary objective was to explore infant feeding as a potential mediator between childcare in infancy and overweight at age 3 years.


After controlling for confounders, children who were cared for in informal childcare (75% grandparents) between the age of 9 months and 3 years were more likely to be overweight than those cared for only by a parent (adjusted risk ratio (aRR)=1.15, 95% confidence interval (CI) 1.04–1.27), particularly if they were in full-time childcare (aRR=1.34, 95% CI 1.15–1.57). When stratifying by socio-economic background, the increased risk of overweight in informal childcare (compared with parental care) was limited to children from more advantaged groups: those whose mother was from a managerial or professional background (aRR=1.23, 95% CI 1.02–1.47), had a degree (RR=1.43, 95% CI 1.13–1.83) or lived in a couple household (RR=1.18, 95% CI 1.06–1.32). There was no association between formal childcare and overweight. Infant feeding did not mediate the association between childcare use in infancy and overweight at age 3 years.


Children from more advantaged families who use informal childcare are at increased risk of overweight. The UK government's drive to support parents into paid employment should be accompanied by health-related information and support for both informal and formal carers. As the majority of informal carers were grandparents, the recent government announcement to provide grandparents with National Insurance credits for caring for grandchildren provides a potential opportunity for health promotion.

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  1. Ogden C, Troiano R, Briefel R, Kuczmarshi R, Flegal K, Johnson C . Prevalence of overweight and among preschool children in the United States, 1971 through 1991. Pediatrics 1994; 99.

  2. Stamatakis E . Anthropometric measurements, overweight and obesity. In: Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and Young People, vol. 1. The Stationery Office: London, 2003.

    Google Scholar 

  3. Wake M, Hardy P, Canterford L, Sawyer M, Carlin J . Overweight, obesity and girth of Australian preschoolers: prevalence and socio-economic correlates. Int J Obes 2007; 31: 1044–1051.

    Article  CAS  Google Scholar 

  4. Griffiths LJ and Hawkins SS . Using the Millennium Cohort Study to examine growth and obesity across childhood. Kohort Spring 2009, CLS.

  5. Hawkins SS, Cole TJ, Law C, the Millennium Cohort Study Child Health Group. An ecological systems approach to examining risk factors for early childhood overweight: findings from the UK Millennium Cohort Study. J Epidemiol Community Health 2008; 63: 147–155.

    Article  Google Scholar 

  6. Armstrong J, Dorosty A, Reilly J, Emmett P, Child Health Information Team. Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study. Arch Dis Child 2003; 88: 671–675.

    Article  CAS  Google Scholar 

  7. Cattaneo A, Monasta L, Stamakatis E, Lioret S, Castetbon K, Frenken F et al. Overweight and obesity in infants and pre-school children in the European Union: a review of existing data. Obes Rev 2009. DOI: 10.1111/j.1467-789X.2009.00639.x

    Article  CAS  Google Scholar 

  8. UNICEF. The childcare transition. A league table of early childhood education and care in economically advanced countries UNICEF. Innocenti Report Card 8 Innocenti Research Centre: Florence, 2009.

  9. Gardner D, Hosking J, Metcalf B, Jeffery A, Voss L, Wilkin T . Contribution of early weight gain to childhood overweight and metabolic health: a longitudinal study (EarlyBird 36). Pediatrics 2009; 123: e67–e73.

    Article  Google Scholar 

  10. Story M, Kaphingst KM, French S . The role of schools in obesity prevention. Future Child 2006; 16: 109–142.

    Article  Google Scholar 

  11. Hawkins SS, Law C . A review of risk factors for overweight in preschool children: a policy perspective. Int J Paediatr Obes 2006; 1: 195–209.

    Article  Google Scholar 

  12. Maher E, Li G, Carter L, Johnson D . Preschool child care participation and obesity at the start of kindergarten. Pediatrics 2008; 122: 322–330.

    Article  Google Scholar 

  13. Kim J, Peterson K . Association of infant child care with infant feeding practices and weight gain among US infants. Arch Pediatr Adolesc Med 2008; 162: 627–633.

    Article  Google Scholar 

  14. Benjamin S, Rifas-Shiman S, Taveras E, Haines J, Finkelstein J, Kleinman K et al. Early child care and adiposity at age 1 and 3 years. Pediatrics 2009; 124: 555–562.

    Article  Google Scholar 

  15. Takahashi E, Yoshida K, Sugimori H, Miyakawa M, Izuno T, Yamagami T et al. Influence factors on the development of obesity in 3-year-old children based on the Toyama Study. Prev Med 1999; 28: 293–296.

    Article  CAS  Google Scholar 

  16. Kagamimori S, Yamagami T, Sokejima S, Numata N, Handa K, Nanri S et al. The relationship between lifestyle, social characteristics and obesity in 3-year-old Japanese children. Child Care Health Dev 1999; 25: 235–247.

    Article  CAS  Google Scholar 

  17. Lumeng J, Gannon K, Appugliese D, Cabral H, Zuckerman B . Preschool child care and risk of overweight in 6- to 12-year old children. Int J Obes 2005; 29: 60–66.

    Article  CAS  Google Scholar 

  18. Maher E, Li G, Carter L, Johnson D . reschool child care participation and obesity at the start of kindergarten. Pediatrics 2008; 122: 322–330.

    Article  Google Scholar 

  19. Plewis I . Millennium Cohort Study: technical report on sampling. 3rd edn, March 2004 Centre for Longitudinal Studies: London, 2004.

  20. Plewis I, Ketende S . Millennium Cohort Study: technical report on response 1st edn, January 2006. Centre for Longitudinal Studies: London, 2006.

    Google Scholar 

  21. Hansen K . Millennium Cohort Study First and Second Surveys: A Guide to the Datasets 1st edn, Centre for Longitudinal Studies: London, 2006.

    Google Scholar 

  22. Michaelsen KF, Weaver L, Branca F, Robertson A . Feeding and Nutrition of Infants and Young Children: Guidelines for the WHO European Region, with Emphasis on the Former Soviet Countries. Vol. 580. World Health Organization: Copenhagen, 2003.

    Google Scholar 

  23. Department of Health. Weaning and the Weaning Diet. Report on Health and Social Subjects no. 45 Stationery Office: London, 1994.

  24. Bates A . Methodology used for producing ONS's small area population estimates. Popul Trends 2006; 125: 30–36.

    Google Scholar 

  25. HM Treasury, Department for Education and Skills, Department for Work and Pensions, and Department of Trade and Industry. Choice for parents, the best start for children: a ten year strategy for childcare 2004. HMSO: Norwich.

  26. Gray A . The changing availability of grandparents as carers and its implications for childcare policy in the UK. J Soc Policy 2002; 34: 557–577.

    Article  Google Scholar 

  27. Philo D, Maplethorpe N, Conolly A, Toomse M . Families with children in Britain: findings from the 2007 Families and Children Study (FACS) Department for Work and Pensions Research Report no. 578. The Stationery Office: Norwich, 2009.

    Google Scholar 

  28. HM Government. New opportunities: fair chances for the future. The Stationery Office: Norwich, 2009.

  29. Lloyd E . The interface between childcare, family support and child poverty strategies under new labour: tensions and contradictions. Social Policy and Society 2008; 7: 479–494.

    Article  Google Scholar 

  30. Wheelcock J, Jones K . Grandparents are the next best thing: informal childcare for working parents in urban Britain. J Soc Policy 2002; 31: 441–463.

    Article  Google Scholar 

  31. HM Treasury. Budget 2009: building Britain's future. Economic and Fiscal Strategy Report and Financial Statement and Budget Report The Stationery Office: London, 2009.

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We thank all the Millennium Cohort families for their participation, and the Director of the Millennium Cohort Study and colleagues in the management team at the Centre for Longitudinal Studies, Institute of Education, University of London.

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Correspondence to C Law.

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Carol Dezateux, Catherine Peckham, Lucy Griffiths, Summer Sherburne Hawkins, Jugnoo Rahi, Tim Cole, Helen Bedford, Carly Rich, Phillippa Cumberland, Richard Pulsford, Flo Kinnafick, Jane Ahn, Sanja Stanojevic, Irina Chris Ster and Richard Jenkins of the Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.

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Pearce, A., Li, L., Abbas, J. et al. Is childcare associated with the risk of overweight and obesity in the early years? Findings from the UK Millennium Cohort Study. Int J Obes 34, 1160–1168 (2010).

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  • preschool children
  • childhood obesity
  • childcare
  • socio-economic inequalities
  • public policy

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