Overweight and obesity often begin in early childhood and can have lasting negative effects on health and quality of life. Early care and education (ECE) programs serve millions of very young children each week and may foster development of healthy lifestyles to prevent obesity. States can support these programs by establishing child care licensing regulations that encourage recommended infant feeding practices; healthy nutrition standards and mealtime practices; opportunities for active play; and less screen time. Achieving a State of Healthy Weight (ASHW) 2019 reports the level of support, nationally, for 47 high-impact obesity prevention standards (HIOPS) in new child care licensing regulations in 2019. (author abstract)