Nutrition

Nutrition is vital to the healthy development and well-being of infants, children, youth, and adults, including those with special health care needs. MCHB’s programs promote the nutritional well-being of maternal and child populations across the lifespan.

Learn more about HRSA's initiatives to support healthy nutrition for families.

State Partnerships

HRSA’s Title V Block Grant Program provides formula grants to 59 states and jurisdictions to design and implement programs and activities that support maternal and child health priorities.

Criteria

Based on state-selected priorities, states/jurisdictions focus on many National Performance Measures (NPMs), which include the following nutrition-related NPMs.

Breastfeeding

  • Percent of infants who are ever breastfed and percent of infants breastfed exclusively through 6 months (selected by 49 states/jurisdictions).

Physical activity

  • Percent of children, ages 6 through 11, who are physically active at least 60 minutes per day (selected by 24 states/jurisdictions).
  • Percent of adolescents, ages 12 through 17, who are physically active at least 60 minutes per day (selected by 24 states/ jurisdictions).
  • Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year (selected by 37 states/jurisdictions).

Strategies

States use Title V grants to develop and implement strategies that support healthy nutrition. Strategies include:

Policy and environmental changes

  • Healthy food access and physical activity strategies through policy and environmental change in at-risk communities.

Breastfeeding

  • A toll-free helpline that provides breastfeeding support.

Language barriers

  • Multi-lingual educational resources for local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agency staff to promote healthy weight to families and children.

Child care centers

  • Collaboration with child care centers to improve practices that support nutrition and physical activity standards in child care settings.
  • Training, technical assistance, and resources to assist child care providers in preventing obesity in young children.

Home visiting

  • Online training for home visitors to prevent obesity by supporting healthy eating and active living for young families.

Nurse trainings

  • Child health nurse trainings on pediatric nutrition assessment, counseling, breastfeeding, and the use of evidence-based federal dietary guidance.

School-based programs

  • Partnerships with schools to create school environments that provide healthy nutrition and opportunities for physical activity throughout the day, including quality physical education.
  • Credentialing for nutrition programs and services at School Health Centers.

Collaborative Improvement and Innovation Networks

Collaborative Improvement and Innovation Networks (CoIINs) are multidisciplinary teams of federal, state, and local leaders working together to tackle a common problem. HRSA’s MCHB uses the CoIIN model to address a variety of nutrition-related needs for families. Nutrition-related CoIIN examples are described below.

Home Visiting

HRSA's Maternal, Infant, and Early Childhood Home Visiting Program supports a CoIIN scale effort to improve breastfeeding practices among mothers and their infants. The two SMART Aims include:

  1. 75% of women intending to breastfeed will initiate breastfeeding and
  2. Among infants whose mothers initiate breastfeeding, 30% of infants will be exclusively breastfed at 3 months, and 15% of infants will be exclusively breastfed at 6 months.

Healthy Weight

The Children’s Healthy Weight State Capacity Building Program launched on September 1, 2020. The purpose is to build state capacity by increasing the MCH nutrition competency of the state Title V workforce and optimizing MCH nutrition-related data sources. The program will develop three-state models (in North Dakota, Oregon, and Washington) that can then be implemented and replicated nationwide. This program builds on lessons learned from, and formative work currently underway in the Children’s Healthy Weight CoIIN (CHW-CoIIN) (PDF - 1.07 MB) Exit Disclaimer.

Using a state-to-state network, the Children’s Healthy Weight CoIIN (CHW-CoIIN) supports State Title V Programs in adopting evidence-based policies and practices related to nutrition, physical activity, and breastfeeding. The goal is to promote healthy weight among children, including those with special health care needs. Currently, 18 state teams representing 13 states participate in the CHW-CoIIN.

This investment builds on the success of the Pediatric Obesity Mini CoIIN (2013-2017) (PDF - 324 KB) Exit Disclaimer, funded jointly by MCHB and the Centers for Disease Control and Prevention (CDC) which supported state health departments in their work related to improving nutrition and physical activity in early care and education settings.

Improving Quality of School-Based Healthcare

The Collaborative Improvement & Innovation Network on School-Based Health Services Exit Disclaimer supports the improvement and growth of school-based health centers and comprehensive school mental health systems. During its initial project period (2014-2018), the program developed a set of five performance measures, including one to address childhood obesity, for national use by school-based health centers to measure the quality of services they provide to students.

MCHB Grand Challenges

Using Technology to Prevent Childhood Obesity in Low-Income Families and Communities is a prize competition comprised of three phases to support innovative technology-based solutions to empower low-income families to achieve and sustain healthy eating practices and healthy lifestyles.

In November 2018, MCHB selected 10 Phase 1 winners of the challenge. Phase 1 winners use various approaches and technology platforms to target different populations, including:

  • Breastfeeding mothers
  • Children ages birth to 19
  • Latino, American Indian, and Alaska Native families
  • Families with children with intellectual and developmental disabilities

In October 2019, MCHB selected 5 Phase 2 winners of the challenge, who will compete in Phase 3 “Demo Days” in April 2021, with final winners announced Spring 2021.

Learn more about HRSA-MCHB Grand Challenges.

Healthy Tomorrows Partnership for Children Program

The Healthy Tomorrows Partnership for Children Program (HTPCP) supports innovative, community-based initiatives to improve the health status of infants, children, adolescents, and families in rural and other underserved communities by increasing their access to preventive care and services. Projects promote the use of guidance from HRSA’s Bright Futures on healthy weight promotion during pediatric visits and in outreach, education, and information dissemination activities. HTPCP also supports projects that provide nutrition and physical activity programming in schools and early childhood centers.

National Center on Early Childhood Health and Wellness

The National Center on Early Childhood Health and Wellness (NCECHW) performs initiatives within early childhood education settings, including nutrition, oral health, and physical activity. Voluntary, evidence-based guidance from NCECHW can be found in the resource Caring for Our Children: National Health and Safety Performance Standards. NCECHW also manages the Little Voices for Healthy Choices Initiative.

Association of State Public Health Nutritionists

HRSA’s partnership with the Association of State Public Health Nutritionists (ASPHN) supports:

Learn more from ASPHN’s brief, Incorporating Nutrition into the Title V MCH Services Block Grant National Performance Measures Exit Disclaimer.

In addition, HRSA partners with ASPHN to support the development and implementation of a community of practice focused on childhood obesity prevention in early care and education settings in rural areas. The community of practice is developing a childhood obesity prevention toolkit, including:

  • Evidence-based and evidence-informed policies and practices
  • Implementation strategies
  • Tools to guide rural-based providers in planning childhood obesity prevention activities

Supporting the MCH Nutrition and Provider Workforce

  • The MCH Nutrition Training Program supports eight centers of excellence in MCH nutrition, including two childhood obesity enhancement projects, to improve access to care through an increased number of practitioners trained in MCH nutrition. The program provides interdisciplinary graduate education and training for students and continuing education and technical assistance at the local, state, and national level, in partnership with State Title V programs.
  • HRSA’s Bright Futures program guides how clinicians can address child health, including obesity prevention. HRSA is developing implementation tools and training resources related to effective weight assessment and healthy weight counseling to integrate Bright Futures into electronic health records.

Expanding Breastfeeding Education, Training, and Services

  • The Breastfeeding Training Initiative under HRSA's Healthy Start Program works to increase breastfeeding initiation and duration rates to those in Healthy People 2020. Staff receives training as Certified Lactation Counselors, and grantees host community workshops on breastfeeding.
  • Through HRSA’s Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, trained professionals meet with at-risk pregnant women and parents with young children in their homes to provide information on a wide range of topics, including breastfeeding and nutrition.
  • The National Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN) aims to increase infant-caregiver adoption of safe infant sleep practices as recommended by the American Academy of Pediatrics (AAP), including breastfeeding, by empowering champions for these protective behaviors within systems that serve families. This project’s cornerston is changing individual behavior on a national scale through a multifaceted approach that promotes common messaging in collaboration with multiple organizations and stakeholders that intersect with infant caregivers through a National Coalition.

Advancing Research on Nutrition in MCH populations

  • The National Survey of Children’s Health (NSCH) provides national and state-level estimates for key indicators of the health and well-being of U.S. children ages 0-17 years. Each year, the NSCH collects information on a variety of topics, including breastfeeding/infant feeding practices, food sufficiency, and obesity.
  • The Pregnancy Related Care Research Network is a national collective of practicing obstetrician-gynecologists recruited to research studies. Studies have focused on metabolic screening, provider familiarity with guidelines on gestational weight gain, and the influence of these guidelines on shifting weight trends.
  • The Healthy Weight Research Network for Children with Autism Spectrum Disorder and other Developmental Disabilities (ASD/DD) Exit Disclaimer is an interdisciplinary research network that leads and promotes coordinated research activities related to promoting healthy weight among children and youth with ASD/DD.
  • MCH Field-Initiated Innovative Research Studies Grants and MCH Secondary Data Analysis Research Grants support investigator-initiated applied maternal and child health research to improve health care services and promote the health and well-being of maternal and child populations.

Partner Resources

Continuing Education and Opportunities

Date Last Reviewed:  September 2020