Parents who dress their children in inappropriate clothing could be inadvertently hampering their child's physical activity in childcare settings. The study, reported in BioMed Central's open access journal, International Journal of Behavioral Nutrition and Physical Activity, suggests that inadequate or inappropriate clothing could restrict children's outdoor play.

Three-quarters of children aged 3-6 years old in the U.S. spend time in childcare and many spend most of their waking hours in these settings. Daily physical activity offers numerous health benefits, and time outdoors has been found to be associated with children's activity levels.

A U.S. team led by Kristen Copeland MD, from Cincinnati Children's Hospital Medical Center, undertook a qualitative study of 53 child-care providers from 34 child-care centers in Cincinnati, Ohio, to examine why physical activity levels may vary across centers. Through a series of focus groups, they found, unexpectedly, that clothing was potentially a significant barrier to children's outdoor physical activity.

Inappropriate clothing included inadequate outdoor clothing, such as a lack of coats and gloves in the wintertime; unsuitable footwear, such as flip flops; and "nice" or expensive outfits that were not to be ruined. The study found that a few children dressed improperly could prevent the entire class from going outside, thus restricting physical activity.

It also emerged that clothing choices were a significant source of conflict between parents and child-care providers. Caregivers suggested several reasons why parents may dress their child inappropriately, including forgetfulness, a rushed morning routine, limited income to buy clothes, a child's preference for a favorite item, and parents not understanding the importance of outdoor play.

The study shows that parents may need education about the importance and benefits of active play for children's development. Copeland said, "Child care centers should consider instigating clear and specific policies regarding the type of clothes permitted at these centers so that children's active play opportunities aren't curtailed".

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November 6, 2009