How fit is the child you look after? Even if he is no more than a toddler, the lifestyle he is leading now could have a significant effect on how healthy he will be in adulthood. It's a sad fact of modern life that many more children seem to be heading straight for heart disease and strokes when they grow up, and even in childhood more will suffer from diabetes and asthma, chronic conditions which can be associated with weight problems. Already research shows that one in ten children under the age of four is seriously overweight. Alarmingly, evidence of heart disease has recently been identified in some under-fives.
While this is disturbing, the good news is that we know why it's happening and can set about doing something to prevent it. Children need to be more physically active and to spend less time sitting passively in front of the television or computer. They also need a diet which is less dominated by processed foods and sugary drinks and to eat regular meals rather than constantly grazing on biscuits, crisps and sweets.
As a nanny there may be a limit to what you can do to help a child become fitter unless you have the co-operation of his parents. They may need to be convinced that there is a problem, particularly if they come from a culture which is more relaxed about chubbiness and where a thin child is likely to cause more concern than a plump one. However, if a two-or three-year-old still has babyhood 'bracelets' of fat around his wrists or if you can feel rolls of fat around his midriff when you give him a cuddle, then it's time to take some action.
It has been estimated that children require 30-minute periods of physical activity at least five times a week in order to keep fit and healthy. Children need to walk, run, skip and jump, not just to maintain a safe weight but also to ensure that they develop a healthy bone structure. Yet current trends seem to conspire to keep our children as inactive as possible.
For instance, most children are transported everywhere by car, however short the journey. Fears about safety on the streets and the pressure to get everywhere as quickly as possible make many of us opt for the car all the time. Children who are used to travelling everywhere by car will probably resist your attempts to get them to walk at first, but there are plenty of ways to coax them along. Walking briskly to the shops, nursery or school is an ideal way to start. Furthermore, getting fresh air and exercise first thing in the morning will help a child - and you - to be more alert and attentive throughout the day. Try to make the walk as pleasant as possible, and if you can choose a route that goes through a park or quiet leafy streets to avoid main roads clogged with traffic, so much the better. Keep the child interested by pointing out things along the way - the variety of birds, the signs of changing seasons, notable buildings - and keep up a steady stream of conversation about what he will be doing that day or what treats you have planned. He will love having your undivided attention and will forget to complain about feeling tired or his legs aching.
Of course, the shops, nursery or school may be too far away to make the journey on foot. However, you could still introduce a bit of exercise into the daily routine by parking a few roads away and walking the rest of the way, or perhaps taking a bus sometimes, which at least means a stroll to and from the bus stop. The aim is to make the child realise that there are alternatives to being carried door to door by car.
Persuading a child to cut down on his television or computer time may prove more difficult. There is nothing wrong with watching his favourite cartoon or playing with a computer game for half an hour or so when he gets home from school, but he certainly should not be allowed to spend more than two hours a day on these pastimes.
Emphasise the fun aspects when you are encouraging a child to take any form of exercise. Organised and competitive sports may be dreaded by children who are overweight. They may well have begun enthusiastically enough, but soon get put off if they can't keep up with the others or get out of breath when they run. Forcing a child to play football or tennis if he really doesn't enjoy it is counterproductive. It will colour his whole attitude to physical exercise and may put him off for life. Swimming is a more relaxed healthy option, but some children hate the noise and the smell of public swimming baths. However, there is a whole range of basic items - such as balls, skipping ropes, hula hoops -which he can use in the privacy of his own home or garden where there is no one to tease or mock him if he gets it wrong.
Make sure you join in the fun. Skipping, for example, is a great way for you to become fitter and leaner too. Cast your mind back to all those ball games and skipping games you used to play as a child. Ask the parents or grandparents about their particular favourites and If you are in need of further inspiration, visit your local library and look for books on children's games.
The second part of your campaign to get a child fitter is to monitor carefully what he is eating and try to reduce the amount of sugary and fatty foods he consumes. A child needs three square meals a day, of which breakfast is the most important and yet often the most difficult to make time for. Get him up a little earlier if necessary so that he can leave the house feeling comfortably full. He will then be much less likely to ask for mid-morning sugary snacks. Meals should always be eaten at the table rather than in front of the television, but don't leave him alone there. Sit with him and chat, even if you are not eating yourself, so that each meal becomes a pleasant social occasion. Formalising meals in this way will also make it much easier for you to control his eating patterns.
Making a conscious effort to give the child healthier options should also encourage you to pay closer attention to your own eating habits and to bring in improvements where necessary. But avoid making your own eating an example to the child. Never tell a child that you are putting him on a diet, and don't make drastic alterations to his food intake without medical advice. You cannot, for instance, put a child on a low-fat diet that you may be following yourself. He should have a well-balanced, varied diet which is rich in calcium, protein, iron and vitamins to ensure healthy growth and provide him with the energy a child needs.
It's essential that your new approach does not cause the child to become obsessed with his weight, or he could develop the sort of psychological problems which lead to eating disorders like anorexia and bulimia. The introduction of a healthier lifestyle should only increase his sense of well-being and self-esteem, not make him self-conscious about his appearance.