Healthy Starts for Infants & Toddler: Shape NC

In fall 2018, the NC Division of Child Development and Early Education launched five infant-toddler projects funded by the Child Care Development Fund Block Grant. This spotlight focused on Healthy Starts for Infants & Toddlers: Shape NC, an infant-toddler health program administered by The North Carolina Partnership for Children (NCPC). 

Building healthy foundations in the first few years of life sets the stage for wellness in childhood and adulthood. However, North Carolina’s youngest children aren’t getting the healthy start they need. As of 2019, three out of every 10 low-income children ages 2-4 in North Carolina were overweight or obese, nearly twice the number of obese young children as there were at the beginning of the decade in 2011.[i]

Promoting healthy eating and physical activity are two proven strategies to increase the number of children entering kindergarten at a healthy weight.[ii] Healthy Starts for Infants & Toddlers: Shape NC (Healthy Starts) is helping to promote physical activity, nutrition, breastfeeding, and food security by partnering with Smart Start Local Partnerships to enhance their technical assistance to child care centers that serve infants and toddlers. Healthy Starts builds on Shape NC, a program for children 0-5 that has been operating in North Carolina since 2010, but focuses solely on infants and toddlers. Healthy Starts currently operates in Wake, Guilford, and Orange counties. Each of the Local Partnerships in these counties selected five child care centers to participate in Healthy Starts.

The needs of infants and toddlers are unique, and Healthy Starts allows for more individualized coaching on topics such as breastfeeding, infant feeding, staff wellness, and the child care centers’ own priorities to address food security, healthy development, and growth. According to Shape NC Manager Stephania Sidberry at NCPC, “Our goal is to have Technical Assistants work with all centers to develop a Healthy Start plan that is unique to the needs of their families. The plan will also include outcomes related to child care center staff, given that many are paid wages that are far below what is needed to sufficiently feed and care for themselves and their families.”

One center implementing Healthy Starts is Lil Treasures Day Care, Inc. in Hillsborough. Director Sharon Tate said that implementing Healthy Starts at Lil Treasures has been a great experience. “The Healthy Starts project has allowed my infants and toddlers to become more active in the classroom and outside of the classroom as well. It has also increased the teachers’ activity with 60 minutes of teacher-led activities daily,” Tate said. “We have also changed a lot of food choices to healthier options in an effort to fight childhood obesity.” These healthier options include more fruits, vegetable, beans, and lean meats served in child care programs.

The first year of Healthy Starts implementation was dedicated to selecting the counties and centers that would receive grant funding and beginning child care center technical assistance on nutrition and physical activity strategies. Now in their second year, 17 centers in Wake, Guilford, and Orange counties are completing their Outdoor Learning Environments, creating breastfeeding-friendly spaces, and developing food security plans.

The Healthy Starts grant ends in September 2021, and the Shape NC team is already thinking about how the next iteration of Healthy Starts and Shape NC will work together to strengthen programs for young children. “We’ve determined that an essential component of the Shape NC model, and one that has the greatest potential for scaling Shape NC outcomes over time, is providing professional supports for the technical assistance workforce (TAs) that work in child care centers,” said Sidberry. “Shape NC staff will continue to create learning spaces for TAs—supporting them in integrating physical health, outdoor learning, and nutrition practices as a means to create healthier center-based environments. We are planning to focus on the full range of TAs in the Smart Start network and in partnership with the network of Child Care Health Consultants.”

For more information, click here or contact Stephania Sidberry at ssidberry@smartstart.org.

For more resources and to learn more about the Coalition’s efforts to support healthy beginnings for infants and toddlers, click here.


[i] Blue Cross Blue Shield of North Carolina Foundation (2020). Healthy Habits Start in Early Childhood. http://www.bcbsncfoundation.org/strategy/healthy-living/early-childhood/

[ii] Robert Wood Johnson Foundation (2016). Schools Can Help Children Eat Healthy and Be Active. https://www.rwjf.org/en/library/research/2016/03/schools-can-help-children-eat-right-and-stay-active.html