Encouraging parents to avoid these practices could assist efforts to reduce childhood obesity
Infants who were fed formula, introduced early to other foods before 4 months of age, fed on a schedule, and/or whose parents watched television while feeding, are at risk for more rapid weight gain in the first year of life compared to infants not fed with these methods, suggests a preliminary study funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Infants who gain weight rapidly before age two are at high risk for obesity in childhood and adulthood. The study authors concluded that helping parents reduce these feeding-related behaviors may help with childhood obesity prevention efforts.
The study was conducted by Esther M. Leerkes, Ph.D., and colleagues at UNC Greensboro. It appears in Pediatric Obesity.
Background
According to the Centers for Disease Control and Prevention, approximately 1 in 5 U.S. children and adolescents have obesity. Children with obesity are more likely to have other health conditions, such as high blood pressure and type 2 diabetes. Children with obesity are also more likely to have obesity as adults. Despite this prevalence, comparatively little is known about how obesity begins in infancy and early childhood.
Results
For the current study, researchers enrolled 299 pregnant women. After the birth of their infants, the study team examined a variety of infant and maternal characteristics and their potential association with rapid infant weight gain in the first six months of life. Researchers visited the mothers when their infants were from 2 to 4 months old and again when they were 6 to 10 months old. The investigators observed infant behavior, observed mothers feeding and interactions with their infants, took physiologic measurements from mothers and infants, tracked infant growth and weight gain, and recorded infant heart rhythms. Mothers also responded to questionnaires on their mood, their infants’ temperament, and on how they fed their infants.
The authors found a strong association between rapid infant weight gain and what they defined as obesogenic feeding practices (i.e., practices suspected of increasing infant weight). The study team identified the following obesogenic feeding practices: formula feeding, introduction of solid foods before 4 months of age, watching television while feeding, lack of breastfeeding, giving a bottle before bedtime, pressuring an infant to finish a bottle, using feeding to soothe a fussy baby, and propping a bottle in place for infants too young to hold a bottle.
Mothers who scored high in certain categories were also more likely than those who scored lower to engage in obesogenic feeding practices. Factors influencing risk included prenatal stress (depressive symptoms, anxiety, a history of stressful life events), a higher body mass index before pregnancy, excessive weight gain during pregnancy, and pregnancy complications, such as preeclampsia and gestational diabetes.
Other factors the study evaluated, such as infant temperament, stress level, and caregivers’ attunement to infant needs, were not significantly associated with infants’ rapid weight gain.
Significance
The authors concluded that efforts to reduce parents’ use of obesogenic feeding practices could ultimately be helpful in reducing the risk of childhood obesity.
“The key take home point is that what and how parents feed their infants in the first 6 months of life has tremendous implications for obesity risk, and childbearing parents who experience more stress during the prenatal period are particularly likely to engage in these unhealthy practices,” said Dr. Leerkes.
She noted that while breast feeding lowers the risk for rapid infant weight gain, many parents can’t breastfeed due to time constraints and other limitations.
“Our findings show that new parents can still prevent excessive weight gain in the first few months of their child's life even if breastfeeding is not a realistic option for them,” she added.
The authors recommended that parents who bottle feed watch for signs the baby could be full, turn off the television, not add cereal, juice, or baby food to a bottle, and refrain from offering a bottle to soothe a baby that is not hungry.
Reference
Leerkes, EM et al. Biopsychosocial predictors of rapid weight gain from birth to 6 months. Pediatric Obesity DOI: 10.1111/ijpo.13170 (2024).
BACK TO TOP