According to the CDC, the prevalence of overweight and obese children has increased greatly over the past twenty years. Children who are overweight or obese are at risk for health complications. The purposes of this study were to determine if providers are using body mass index (BMI) as a screening tool at well child visits, and discussing the importance of nutrition, physical activity and limited TV/media time. This quantitative study was accomplished through a retrospective review of 174 medical charts at three Midwestern pediatric care settings. Findings revealed that BMI was documented in the record 33.9% (n=59), nutritional counseling was documented 70.7% ( n=123), physical activity was documented 48.9% ( n=89), and TV/media time was documented 39.7% (n=69).Based on evidence in the current literature and in this study, there is evident underutilization of BMI screening at well-child visits, as well as counseling in areas of nutrition, physical activity and media time.