Prevention in practice

How primary health care nurses can help shape healthy beginnings 

Konsita Kuswara, Postdoctoral Research Fellow, NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood, University of Sydney; Emalie Rosewarne, Senior Lecturer, School of Health Sciences, UNSW Sydney; Jessica Appleton, Senior Lecturer, School of Nursing and Midwifery, University of Technology Sydney; Sarah Taki, Senior Researcher, Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District; Li Ming Wen, Clinical Professor, Sydney School of Public Health, University of Sydney; Elizabeth Denney-Wilson, Professor of Nursing, Susan Wakil School of Nursing and Midwifery, University of Sydney; and Louise Baur, Paediatrician and Professor of Child and Adolescent Health, Children’s Hospital at Westmead Clinical School, University of Sydney.

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According to recent data from the Australian Bureau of Statistics, one in five children in Australia start school with overweight or obesity. This affects their health, wellbeing and long-term disease risk. Early childhood is a critical period to establish healthy eating, movement and sleep habits. Primary health care (PHC) nurses build trusted relationships with families and are well placed to use routine encounters to support healthy growth from the start. 

Why early prevention matters  

The 2022 National Health Survey showed that only around 20% of children aged 2–4 years consume enough vegetables and by 8 years this falls to just 2%.¹ Many children (83%) aged 2–5 years also fail to meet both physical activity and screen time recommendations.² Children who maintain a healthy weight in early life are far more likely to remain at a healthy weight in adulthood,³ emphasising the importance of obesity prevention in early life. Interventions that support parents/carers and promote healthy feeding, play and sleep behaviours from infancy have shown promise in improving children’s growth trajectories and health behaviours.^4–6 

The reality of prevention 

Parents want the best for their children, yet day-to-day demands on parenting often make supporting healthy diet and movement behaviours challenging, particularly amidst cost-of-living pressures, busy schedules, variable access to services and pervasive marketing of unhealthy foods. In this context, health professionals remain a trusted source of advice. 

In 2025, we did a study where we spoke with 33 PHC practitioners, managers and policy leaders representing child and family health and general practice sectors in Australia. The aim of the study was to understand the barriers and enablers of promoting healthy eating and movement behaviours in their routine care. We found that in general practice, the promotion of healthy eating and movement behaviours for young children was often opportunistic. Few consultations are funded specifically for primary prevention beyond immunisation, postnatal care and, in some jurisdictions, school entry health checks. As a result, conversations about nutrition, physical activity and growth, if they occur, are fitted around more immediate clinical concerns. PHC practitioners also described the challenges of raising weight-related issues in brief appointments, navigating potential weight stigma and providing healthy living advice in the context of environmental and structural barriers that can limit families’ capacity to act.  

Our study also highlighted gaps in coordination across early childhood health services. While maternal, child and family health services are designed for prevention and early intervention, not all families engage with these services. General practice is often a common touchpoint with families, but given prevention is often opportunistic, discussions about healthy growth and associated behaviours may be limited and not tailored to families’ specific needs. Stronger connections between services and consistent messaging on healthy growth, nutrition and physical activity are therefore important. 

Practical strategies for PHC nurses to promote healthy child growth 

Despite these challenges, there are clear opportunities for PHC nurses to better support healthy growth in young children. PHC nurses are greatly valued for their skills in being able to engage with children and families effectively, undertake growth monitoring and work collaboratively with GPs to address concerns about growth and health behaviours. Here are some practical ways to promote healthy child growth. 

Conduct routine growth monitoring 

Conducting growth monitoring often provides a natural flow to discussions around feeding, active play and screen time. There may be opportunities to proactively take children’s growth measurements while they’re waiting for their appointments and to supplement brief conversations around growth, feeding, play and sleep with follow-up resources or referrals, if appropriate. If your practice does not routinely do growth measurements, you could advocate for it to be embedded in the practice as appropriate.  

If you need a refresher on child growth monitoring, the Royal Children’s Hospital has free e-modules.

Make every encounter count with key prevention messages 

Use simple, consistent key messages to promote healthy growth during routine encounters with families. Key messages help cover the most important topics and are easy for both practitioners and parents to remember. They also create shared language within the practice when discussing nutrition, physical activity, sleep and screen time. 

Focus on empowering parents to model and enable healthy routines at home from infancy. Encourage responsive feeding, offering healthy food choices, engaging in active play, establishing regular sleep routines and limiting recreational screen time. The following resources provide practical guidance that can be helpful when discussing these behaviours with parents: 

• NSW Health, ‘8 Healthy Habits’ (for children aged 12–24 months, PDF brochure) 

• healthybeginnings.org.au (parent resources) 

• INFANT Program (parent resources, website and app) 

• healthychildren.org, ‘Healthy Active Living for Families: The 5-2-1-0 Approach’ 

• Karitane.com.au, ‘Resource Library’ (parent resources, available in multiple languages) and ‘Professionals' Webinars’ (webinar series for child health professionals exploring early childhood nutrition and other topics). 

Manage potential weight stigma 

Evidence shows that focusing on blame or individual responsibility does not improve weight or health behaviour outcomes and can discourage families from engaging with care. A strength-based approach encourages families to build on existing positive habits and make small, achievable changes that support healthy growth. The following resources provide practical guidance on how to navigate conversations about weight sensitively and support families in a constructive way: 

• Karitane.com.au, ‘Talking to Families about Healthy Growth and Development’ (recorded webinar on practical communication strategies) 

• Children's Health Queensland, ‘Healthy Kids: Sensitive Conversations with Families’ (recorded webinar designed for early childhood educators, with strategies generalisable to nursing practice)  

• The Obesity Collective, ‘Understanding the Science and Reality of Obesity for Better Patient Care’ (1-hour accredited CPD e-module) 

• Hill et al., ‘Supporting Healthcare Professionals to Reduce Weight Stigma’⁷ (professional article with practical recommendations). 

Referrals and parent resources 

We recommend connecting with programs or services in your area that provide more in-depth promotion or support for child nutrition and physical activity (see the text box). These services can act as a soft entry point to allied health services, such as dietitians or physiotherapists, for families seeking personalised support. 

Be a prevention champion 

Be a champion within your practice to ensure that primary prevention, including in early childhood, is embedded in the service agenda. This may involve contributing to policies that support primary prevention and orienting or training new staff to include opportunistic prevention as part of routine care. 

If you can have an influence at the structural level, advocate for a stronger, more coordinated system where prevention is embedded across primary health care. A recent article by Gooey et al. provides detailed advice on how to do this.⁸ 

Conclusions 

PHC nurses play a vital role in giving children a healthy start. Although preventive care can be challenging in busy services, brief and consistent health promotion can be embedded in everyday encounters with young families. This article has outlined practical strategies and resources to support families and encourage healthy growth. Small conversations matter, and over time they can influence lifelong health. By embracing prevention in routine care, PHC nurses can be powerful agents of change in early childhood health. 

Programs and services promoting child nutrition and physical activity  Australian Capital Territory  Canberra Maternal, Child and Family Health Services – Well child health checks and parenting support from pregnancy to early childhood  Feeding Healthy Futures – A healthy eating group education program for expectant and new parents  Nourishing Little Minds – An experiential play-based program to increase interest and exposure to foods, often held in ACT libraries  Kids at Play Active Play Program – Workshops and resources for parents and early childhood educators to encourage fundamental movement skills and reduce screen time  ACT Government Child Development Service – A range of services and workshops to support child development  New South Wales  Local Health District Community Health – Early intervention and child development support from allied health and child health clinicians  Healthy Beginnings – A free text-messaging program focused on supporting families with early childhood health behaviours (currently available through Hunter New England Local Health District)  Tresillian and Karitane – Parenting and early childhood health and development support  Go4Fun – A healthy lifestyle program for primary school children   PICNIC (Mid North Coast Local Health District) – Community program supporting healthy eating and active living  Northern Territory  Healthy Living NT – Programs and parent resources promoting healthy eating and activity behaviours in early childhood  NT Government Child Health Service – Universal services supporting child development and parenting  Queensland  Deadly Choices – Program supporting healthy diet and physical activity habits for Aboriginal and Torres Strait Islander communities  Growing Good Habits – Resources for family and health professionals to support healthy eating and physical activity routines in early childhood   QLD Government Child, Youth and Family Health Services – Universal services supporting child development and parenting  South Australia  Better Health Coaching Service – Early intervention service supporting lifestyle changes for adults  SA Government Child and Family Health Services – Universal services providing parenting and child (0–5 years) health support  Tasmania  Move Well Eat Well – Initiative supporting healthy eating and physical activity in schools and early childhood settings  Tresillian – Parenting and early childhood health and development support   TAS Government Child Health and Parenting Service – Universal services supporting child development and parenting  Victoria  INFANT – A maternal and child health program and app supporting healthy infant feeding, activity and growth  VIC Government Maternal and Child Health Services and Early Parenting Centres – Universal services supporting child development and parenting  Western Australia  Active8 – Program encouraging physical activity and healthy eating for children  Better Health Program – A free healthy lifestyle program for families with primary school aged children  Ngala – A range of services to support families navigate parenting challenges and promote children’s health and development  WA Government Community Child Health Services – Universal services supporting child development and parenting

References 

1. Australian Institute of Health and Welfare (AIHW), Diet, AIHW website, 17 June 2024, accessed 2 April 2026. 

2. Australian Institute of Health and Welfare (AIHW), Physical activity, AIHW website, 17 June 2024, accessed 2 April 2026. 

3. AJ Hayes, JP Carrello, PJ Kelly, A Killedar and LA Baur, ‘Looking backwards and forwards: tracking and persistence of weight status between early childhood and adolescence’, Int J Obes, 2021, 45(4):870–878, doi:10.1038/s41366-021-00751-3. 

4. LM Wen, C Rissel, H Xu et al., ‘Effects of telephone and short message service support on infant feeding practices, “tummy time,” and screen time at 6 and 12 months of child age: a 3-group randomized clinical trial’, JAMA Pediatr, 2020, 174(7):657–664, doi:10.1001/jamapediatrics.2020.0215. 

5. M Zheng, AJ Cameron, CS Birken, C Keown-Stoneman, R Laws, LM Wen and KJ Campbell, ‘Early infant feeding and BMI trajectories in the first 5 years of life’, Obesity, 2020, 28(2):339–346, doi:10.1002/oby.22688. 

6. KD Hesketh, J Salmon, SA McNaughton et al., ‘Long-term outcomes (2 and 3.5 years post-intervention) of the INFANT early childhood intervention to improve health behaviors and reduce obesity: cluster randomised controlled trial follow-up’, Int J Behav Nutr Phys Act, 2020, 17(1):95, doi:10.1186/s12966-020-00994-9. 

7. B Hill, X de la Piedad Garcia, JA Rathbone et al., ‘Supporting healthcare professionals to reduce weight stigma’, Aust J Gen Pract, 2024, 53(9):682–685, doi:10.31128/AJGP-07-23-6906. 

8. M Gooey, D Dutch, E House and K West, ‘Embedding child health promotion and preventive care within primary health care: from agenda to action’, Health Promot J Austr, 2025, 36(2):e70027, doi:10.1002/hpja.70027.