591 EARLY NUTRITIONAL ASSESSMENT: EFFECTIVE MANAGEMENT FOR OVERWEIGHT AND OBESITY

Abstract

25/261 children were identified as overweight or obese within the first two years of life during well-child care (provided to them from birth to four years.) Their mothers were enrolled during pregnancy in a longitudinal study to determine the effects of maternal nutrition and environmental factors on the infants' subsequent growth and development. At every routine visit growth assessment and nutritional guidance were provided. When growth was inappropriate, intervention occurred with increased emphasis on appropriate growth rate & specific dietary recommendations. Data indicate 1)considered alone, dietary intake, anthropometric assessment, growth velocity, or physical exam will not identify inappropriate growth rate as early as when all are considered together; 2) the earlier identification occurs, the greater possibility of problem resolution. Of the 25 identified with obese status, 9 have resolved, 13 are resolving; 3 have not. The pediatric literature indicates a success rate of between 25-50% for obesity intervention, compared to our rate of 88% with a minimum of six months follow-up. Characteristics of children and families influencing inappropriate growth included: excess parental weight status, poor eating patterns, excess maternal weight gain in pregnancy, presence of extended family or babysitter care. The investigation emphasizes the need for comprehensive nutritional assessment regularly throughout the first several years of life and the value of early intervention.