Healthy Feeding Practices Research Articles

Which family-centered educational interventions are effective for preventing childhood obesity?

EVIDENCE-BASED ANSWER Parental education on appropriate introduction of healthy solid feeding practices, recognizing infant hunger and satiety cues, and encouraging active play leads to lower BMI-for-age Z-score (BMIZ), weight-forlength percentile measures, and overall BMI in infancy (SOR: B, 1 RCT using each outcome). Effect on weight beyond 1 and 2 years old and effect on other health measures are unknown.

Parental Feeding Behaviors and Weight-Related Concerns in Children With Special Needs.

Parental feeding behaviors and concern about child weight are associated with obesity among youth who are typically developing. Little is known about this relationship among parents of youth with special needs, despite these children having higher obesity risk. This study used an online survey to explore associations among parental feeding behaviors, parent weight concerns, demographics, and child weight status in a sample of 356 parents of children diagnosed with autism spectrum disorder, spina bifida, and Down syndrome. Specific parental feeding behaviors were significantly related to the child's weight and intensified when the parent was concerned about the child's weight. Child's diagnosis, family income, parent age, and parent gender influenced select feeding behaviors. Obesity has significant health ramifications and negatively affects an individual's ability to self-manage, which is crucial in individuals with special needs. These findings present an opportunity for the health care community to educate and promote healthy feeding practices in this vulnerable population.

A qualitative systematic review of maternal infant feeding practices in transitioning from milk feeds to family foods.

Evidence supports the establishment of healthy feeding practices early in life to promote lifelong healthy eating patterns protective against chronic disease such as obesity. Current early childhood obesity prevention interventions are built on extant understandings of how feeding practices relate to infant's cues of hunger and satiety. Further insights regarding factors that influence feeding behaviors in early life may improve program designs and outcomes. Four electronic databases were searched for peer-reviewed qualitative studies published between 2000 to 2014 with transitional infant feeding practice rationale from developed countries. Reporting transparency and potential bias was assessed using the Consolidated Criteria for Reporting Qualitative Research quality checklist. Thematic synthesis of 23 manuscripts identified three themes (and six sub-themes): Theme 1. Infant (physical cues and behavioural cues) focuses on the perceived signs of readiness to start solids and the feeding to influence growth and "health happiness." Theme 2. Mother (coping strategies and knowledge and skills) focuses on the early survival of the infant and the family and the feeding to satisfy hunger and influence infant contentment, and sleep. Theme 3. Community (pressure and inconsistent advice) highlights the importance of generational feeding and how conflicting feeding advice led many mothers to adopt valued familial or culturally established practices. Overall, mothers were pivotal to feeding decisions. Satisfying infant's needs to reach "good mothering" status as measured by societal expectations was highly valued but lacked consideration of nutrition, obesity, and long term health. Maternal interpretation of healthy infant feeding and successful parenting need attention when developing strategies to support new families.

A Comparison of Recruitment Methods for an mHealth Intervention Targeting Mothers: Lessons from the Growing Healthy Program.

BackgroundMobile health (mHealth) programs hold great promise for increasing the reach of public health interventions. However, mHealth is a relatively new field of research, presenting unique challenges for researchers. A key challenge is understanding the relative effectiveness and cost of various methods of recruitment to mHealth programs.ObjectiveThe objectives of this study were to (1) compare the effectiveness of various methods of recruitment to an mHealth intervention targeting healthy infant feeding practices, and (2) explore factors influencing practitioner referral to the intervention.MethodsThe Growing healthy study used a quasi-experimental design with an mHealth intervention group and a concurrent nonrandomized comparison group. Eligibility criteria included: expectant parents (>30 weeks of gestation) or parents with an infant <3 months old, ability to read and understand English, own a mobile phone, ≥18 years old, and living in Australia. Recruitment to the mHealth program consisted of: (1) practitioner-led recruitment through Maternal and Child Health nurses, midwives, and nurses in general practice; (2) face-to-face recruitment by researchers; and (3) online recruitment. Participants’ baseline surveys provided information regarding how participants heard about the study, and their sociodemographic details. Costs per participant recruited were calculated by taking into account direct advertising costs and researcher time/travel costs. Practitioner feedback relating to the recruitment process was obtained through a follow-up survey and qualitative interviews.ResultsA total of 300 participants were recruited to the mHealth intervention. The cost per participant recruited was lowest for online recruitment (AUD $14) and highest for practice nurse recruitment (AUD $586). Just over half of the intervention group (50.3%, 151/300) were recruited online over a 22-week period compared to practitioner recruitment (29.3%, 88/300 over 46 weeks) and face-to-face recruitment by researchers (7.3%, 22/300 over 18 weeks). No significant differences were observed in participant sociodemographic characteristics between recruitment methods, with the exception that practitioner/face-to-face recruitment resulted in a higher proportion of first-time parents (68% versus 48%, P=.002). Less than half of the practitioners surveyed reported referring to the program often or most of the time. Key barriers to practitioner referral included lack of time, difficulty remembering to refer, staff changes, lack of parental engagement, and practitioner difficulty in accessing the app.ConclusionsOnline recruitment using parenting-related Facebook pages was the most cost effective and timely method of recruitment to an mHealth intervention targeting parents of young infants. Consideration needs to be given to addressing practitioner barriers to referral, to further explore if this can be a viable method of recruitment.

Potential Use of Food/Activity, Parenting Style, and Caregiver Feeding Style Measurement Tools with American Indian Families: A Brief Report.

Objective To provide preliminary descriptive data on caregiver and child weight status, parenting styles, feeding styles, and feeding practices of a small American Indian sample. Methods Participants included a subsample of American Indian caregivers (n=23) identified from a larger study that was conducted in five states. Using previously validated instruments, means, standard deviations, and ranges for general parenting styles, feeding styles, and feeding practices were explored. Results In general, most caregivers reported healthy feeding practices. Most caregivers scored higher on responsive compared to restrictive or permissive in general parenting. Of the sample, 12 caregivers (52.2%) were classified in the indulgent feeding style category, 5 caregivers (21.7%) were classified as authoritative, 5 (21.7%) uninvolved, and 1 (4.3%) authoritarian. Conclusions More investigations are needed to explore questions raised by this study about using common tools that measure childhood obesity with American Indian families.

Preschoolers' influence on and help with beverage selection at the grocery store is linked to maternal responsiveness and child beverage intake: An exploratory study

Children's involvement in beverage selection or purchase has seldom been investigated. The responsiveness dimension of parental feeding styles has been related to healthy maternal feeding practices. Assessing mothers' reports of responsiveness and demandingness in grocery stores may shed light on influences on purchases of sugar-sweetened beverages (SSB) and fruit juice (FJ). Study objectives were to explore whether (1) maternal responsiveness and demandingness were associated with preschoolers' a) help with selection of and b) influence on SSB and FJ purchases during grocery shopping and whether (2) preschoolers' a) help with selection of and b) influence on SSB and FJ purchases were associated with child intake of these beverages. Mothers of 3-to-5-year-old children (n=185) who co-shopped with the child completed the Caregiver Feeding Style Questionnaire, reported frequency of child help with selection and influence on beverage purchase via questionnaire, and provided a one-day weekend food recall for the child. In adjusted logistic regressions, responsiveness was associated with child help selecting FJ (OR=6.50, 95% CI[1.04, 40.75], p<0.05), but not SSB. In multiple regressions, children who frequently helped select or influenced SSB purchases had higher SSB intake, b(SE)=3.63(1.40), t(176)=2.59, and b(SE)=3.18(1.25), t(176)=2.53, p<0.05. Mothers with higher responsiveness were more likely to let their preschoolers select FJ but not SSB during shopping. Children who frequently helped select or influenced SSB purchases had higher SSB intake than children who did so infrequently. Additional parenting behaviors associated with grocery shopping should be explored.

Evaluation of the Transdisciplinary Obesity Prevention Research Sciences Program

To develop and evaluate an applied research methods curriculum for undergraduates on the causes and consequences of childhood obesity. The Transdisciplinary Obesity Prevention Research Sciences Program (TOPRS) has been developed by a multidisciplinary team from the University of Illinois at Urbana-Champaign, Purdue University, and California State University, Fresno. Students learn about the causes, consequences and correlates of obesity from an ecological framework from cell to society. The class format is a “flipped” version with students viewing 10 minute microlectures and class time spent in interactive discussions and activities focusing on research design and methodologies. Each micro-lecture is presented by national experts in nutritional sciences, animal science, child development, early care and education, community health, and public health. A pilot study included 53 undergraduate students at two institutions. Pre-and-post changes in nutrition related knowledge, confidence in research skills, and interest in attending graduate school were measured. A significant change in knowledge was found in the following areas: breastfeeding and pediatric nutrition, changing food environment and media, culturally relevant interventions focused on increasing healthy eating, childcare & feeding practices, family mealtimes and nutrition, and diabetes. Additionally, at the end of the course students were more confident in their research skills and also more likely to consider attending graduate or professional school. The innovative curriculum was effective at increasing nutrition related knowledge, research skills, and interest in graduate school. The curriculum represents a model for integrative, interdisciplinary program development and will be available for dissemination.

A qualitative study of the infant feeding beliefs and behaviours of mothers with low educational attainment.

BackgroundInfancy is an important period for the promotion of healthy eating, diet and weight. However little is known about how best to engage caregivers of infants in healthy eating programs. This is particularly true for caregivers, infants and children from socioeconomically disadvantaged backgrounds who experience greater rates of overweight and obesity yet are more challenging to reach in health programs. Behaviour change interventions targeting parent-infant feeding interactions are more likely to be effective if assumptions about what needs to change for the target behaviours to occur are identified. As such we explored the precursors of key obesity promoting infant feeding practices in mothers with low educational attainment.MethodsOne–on–one semi-structured telephone interviews were developed around the Capability Opportunity Motivation Behaviour (COM-B) framework and applied to parental feeding practices associated with infant excess or healthy weight gain. The target behaviours and their competing alternatives were (a) initiating breastfeeding/formula feeding, (b) prolonging breastfeeding/replacing breast milk with formula, (c) best practice formula preparation/sub-optimal formula preparation, (d) delaying the introduction of solid foods until around six months of age/introducing solids earlier than four months of age, and (e) introducing healthy first foods/introducing unhealthy first foods, and (f) feeding to appetite/use of non-nutritive (i.e., feeding for reasons other than hunger) feeding. The participants’ education level was used as the indicator of socioeconomic disadvantage. Two researchers independently undertook thematic analysis.ResultsParticipants were 29 mothers of infants aged 2–11 months. The COM-B elements of Social and Environmental Opportunity, Psychological Capability, and Reflective Motivation were the key elements identified as determinants of a mother’s likelihood to adopt the healthy target behaviours although the relative importance of each of the COM-B factors varied with each of the target feeding behaviours.ConclusionsInterventions targeting healthy infant feeding practices should be tailored to the unique factors that may influence mothers’ various feeding practices, taking into account motivational and social influences.

Differences in the Protective Effect of Exclusive Breastfeeding on Child Overweight and Obesity by Mother's Race.

Objectives To examine the relationship between infant feeding and risk of child overweight and obesity across race and ethnicity in a diverse community-based cohort. Methods 2172 mother baby dyads were drawn from a prospective cohort constructed using data from electronic medical records linked to birth records. The primary exposure was exclusive breastfeeding at 2months of age; outcome was BMI Z-score and BMI≥85th percentile (overweight and obese) at 4years of age. Regression models were adjusted for confounding using covariance balanced propensity score and inverse probability weighting. Results At age 4, exclusively breast fed children had lower BMI Z-score (-0.109, SE=0.048) and a decreased odds of a BMI≥85th percentile (0.832; 95% CI 0.792, 0.994), when compared to those exclusively formula-fed or had mixed feeding. Race and ethnicity significantly moderated these associations. Sub-population analysis showed the effect was significant for BMI Z-score (p=0.0002) and BMI≥85th percentile (p<0.0001) only for children of NH white mothers. For children of NH black mothers exclusive breastfeeding was not associated with a significant difference in BMI Z-score, however there was an increased odds of overweight or obesity (p=0.0145). Conclusions The protective effect of breastfeeding against early childhood overweight and obesity may differ by race and ethnicity. This suggests that programs aiming to reduce obesity by increasing rates of breastfeeding may have limited impact for some groups and should be coupled with other racially and ethnically focused efforts to encourage healthy feeding practices in infancy and early childhood.

Urban-Rural Differences in Healthy Breast Feeding Practices in India: Implications for Child Malnutrition

Urban-Rural Differences in Healthy Breast Feeding Practices in India: Implications for Child Malnutrition

Study protocol for a multi-component kindergarten-based intervention to promote healthy diets in toddlers: a cluster randomized trial.

BackgroundThere is concern about the lack of diversity in children’s diets, particularly low intakes of fruit and vegetables and high intakes of unhealthy processed food. This may be a factor in the rising prevalence of obesity. A reason for the lack of diversity in children’s diets may be food neophobia. This study aimed to promote a healthy and varied diet among toddlers in kindergarten. The primary objectives were to reduce food neophobia in toddlers, and promote healthy feeding practices among kindergarten staff and parents. Secondary objectives were to increase food variety in toddlers’ diets and reduce future overweight and obesity in these children.MethodsThis is an ongoing, cluster randomized trial. The intervention finished in 2014, but follow-up data collection is not yet complete. Eighteen randomly selected kindergartens located in two counties in Norway with enrolled children born in 2012 participated in the intervention. The kindergartens were matched into pairs based on background information, and randomly assigned to the intervention or control groups.A 9-week multi-component intervention was implemented, with four main elements: 1) kindergarten staff implemented a pedagogical tool (Sapere method) in daily sessions to promote willingness to try new food; 2) kindergarten staff prepared and served the toddlers a cooked lunch from a menu corresponding to the pedagogical sessions; 3) kindergarten staff were encouraged to follow 10 meal principles on modeling, responsive feeding, repeated exposure, and enjoyable meals; and 4) parents were encouraged to read information and apply relevant feeding practices at home. The control group continued their usual practices. Preference taste tests were conducted to evaluate behavioral food neophobia, and children’s height and weight were measured. Parents and staff completed questionnaires before and after the intervention. Data have not yet been analyzed.DiscussionThis study provides new knowledge about whether or not a Sapere-sensory education and healthy meal intervention targeting children, kindergarten staff, and parents will: reduce levels of food neophobia in toddlers; improve parental and kindergarten feeding practices; improve children’s dietary variety; and reduce childhood overweight and obesity.Trial registrationISRCTN74823448 DOI 10.1186/ISRCTN74823448

Implementation of parental feeding practices: does parenting style matter?

To combat childhood obesity, researchers have focused on parental feeding practices that promote child health. The current study investigated how parenting style relates to twelve parental feeding practices. Data on parenting style and parental feeding practices were obtained for a correlational study from users of Amazon's Mechanical Turk, an online survey system. USA. Mothers of children aged 7-11 years (n 193). Parenting style related differentially to eleven out of the twelve measured practices. Authoritative mothers displayed more feeding practices that promote child health and fewer practices that impede child health. Authoritarian and permissive mothers displayed more unhealthy practices than authoritative mothers, but differed from each other on the practices they employed. Parenting style may relate to more aspects of feeding than previously realized. The inclusion of numerous healthy feeding practices along with unhealthy practices in the current study provides suggestions for the application of healthy feeding behaviours. Instruction on feeding behaviours and parenting style should be a focus of future educational programmes.

Anemia and micronutrient deficiencies in infants attending at Primary Health Care in Rio Branco, Acre, Brazil.

The present study investigated the factors associated with anemia and micronutrient deficiencies in a cross-sectional analysis conducted with 150 children aged 11 to 14 months attending at basic health centers in Rio Branco, Acre. Venous blood samples were obtained to assess the occurrence of anemia and deficiencies of iron (ID), vitamin A (VAD), and B12 (VB12D). Multiple Poisson regression models were used to identify factors associated with anemia. Anemia, ID, VAD and B12D were observed in 23%, 76%, 18% and 20% of children, respectively. The factors associated with anemia were: do not be only child, living in households without access to cable TV or internet, stunting, late introduction of the complementary feeding (more than 240 days), VAD, VB12D, and current evidence of infection (plasma CRP > 5 mg/L). There was a lower prevalence of anemia among children with birth weight > 3,500 g. Overall, 82% of the study children had at least one of the micronutrient deficiencies (ID, VAD and VB12D). Actions with emphasis on timely and healthy feeding practices, better management of morbidities and supplementation with other micronutrients should be focused on the improvement of child care services at primary health care in this county.

Exploration of mothers’ engagement with the Growing healthy program: a week by week app to promote healthy infant feeding practices

Event Abstract Back to Event Exploration of mothers’ engagement with the Growing healthy program: a week by week app to promote healthy infant feeding practices Sarah Taki1, 2*, Georgina Russell1, 2, Karen Campbell2, 3, Rachel Laws2, 3 and Elizabeth Denney-Wilson1, 2 1 University of Technology Sydney, Australia 2 Centre for Obesity Managment & Prevention Research Excellence in Primary Health Care, Australia 3 Deakn University, Australia Introduction Interventions for the prevention of childhood obesity are vital if the current trends in obesity are to be reversed. Participation and take-up of interventions is crucial to the success, but little work has explored participant engagement with interventions and effects on intervention outcomes. We aimed to explore factors that influenced mothers’ engagement with the Growing healthy program: a mHealth intervention targeting healthy infant feeding practices for socio-economically disadvantaged mothers. Methods/ Results One–on–one semi-structured telephone interviews were conducted with a purposeful sample of mothers (n=20) participating in the Growing healthy program when their babies were 9 months old. Participants with high and low levels of engagement were sampled. The interview guide explored the perceptions of the various features of the app known to affect engagement. These included usability, delivery of the program, quality, design and navigation of the app. Participants varied in their level of engagement with the app, as derived from the app analytics (e.g. number of pages viewed). Data were analysed using a thematic analysis approach. This study will present the features of the app that mothers found useful and engaging and also identify features that were unhelpful or disliked (results are forthcoming) thus identifying opportunities for improving app design and heightening engagement strategies in obesity prevention interventions. Conclusions/implications This is the first study to develop and implement an app supporting mothers with healthy infant feeding behaviours and provides insights to assist further child obesity interventions. Acknowledgements The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian government Department of Health and Ageing. The information and opinions contained in it do not necessarily reflect the views or policies of the Australian Primary Health Care Research Institute or the Australian government Department of Health and Ageing. Keywords: Infant feeding, Mothers, mHealth, APP, engagement Conference: 2nd Behaviour Change Conference: Digital Health and Wellbeing, London, United Kingdom, 24 Feb - 25 Feb, 2016. Presentation Type: Poster presentation Topic: Academic Citation: Taki S, Russell G, Campbell K, Laws R and Denney-Wilson E (2016). Exploration of mothers’ engagement with the Growing healthy program: a week by week app to promote healthy infant feeding practices. Front. Public Health. Conference Abstract: 2nd Behaviour Change Conference: Digital Health and Wellbeing. doi: 10.3389/conf.FPUBH.2016.01.00110 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 27 Nov 2015; Published Online: 09 Jan 2016. * Correspondence: Ms. Sarah Taki, University of Technology Sydney, Sydney, Australia, sarah_taki@hotmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Sarah Taki Georgina Russell Karen Campbell Rachel Laws Elizabeth Denney-Wilson Google Sarah Taki Georgina Russell Karen Campbell Rachel Laws Elizabeth Denney-Wilson Google Scholar Sarah Taki Georgina Russell Karen Campbell Rachel Laws Elizabeth Denney-Wilson PubMed Sarah Taki Georgina Russell Karen Campbell Rachel Laws Elizabeth Denney-Wilson Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Development and preliminary evaluation of the Child Feeding Guide website and app: A tool to support caregivers with promoting healthy eating in children

Background: Fussy eating in young children is very common, with at least 50% of parents reporting having a fussy child. Eating behaviours established early in life tend to remain throughout childhood and into adulthood, so ensuring that children develop healthy eating behaviours from their earliest years is vital. Fussy children often refuse to eat healthy foods, like fruit and vegetables, but favour high-calorie foods instead. Diets low in fruit and vegetables have been linked to a number of preventable health conditions, such as diabetes and cancers, as well as to overweight and obesity. Fussy child eating behaviours can also cause anxiety and stress in caregivers, which can perpetuate the problem. Despite an abundance of available support for introducing complementary foods, practical advice about child feeding once weaning has occurred is lacking. Moreover, caregivers find available resources about feeding young children and promoting healthy eating to be “too basic” and have called for evidence-based, credible resources to help them manage children’s difficult or fussy eating behaviours. Empowering caregivers to effectively manage fussy eating behaviours and improve health in their children will likely prevent these eating behaviours from becoming engrained and reduce the number of children eating unhealthy or limited diets. Aim: To address the lack of child feeding support for caregivers by developing an evidence-based, credible and accessible support resource to promote healthy eating habits in young children and healthy feeding practices in caregivers. Method: Following a review of the literature and consultation with caregivers, the Child Feeding Guide was developed. The Child Feeding Guide is a website and free mobile app which offers information, advice and tools to help caregivers manage fussy eating behaviours. An online format was used to ensure the Child Feeding Guide is accessible and that a diverse range of caregivers can benefit from it. Health professionals and caregivers with young children were asked to use the newly-developed Child Feeding Guide and provide feedback on its usability, content, appearance and novelty. Results: Over 85% of health professionals agreed that the Child Feeding Guide contains useful information, is a beneficial resource, and is easy to use. 95% would recommend it to the families that they work with. 80% of caregivers reported that using it helped them to better understand their children’s eating behaviour. Caregivers commented that using the Child Feeding Guide had made them aware of how their feeding behaviours can inadvertently affect their child. Other features of the Child Feeding Guide were identified as beneficial, such as: the provision of advice alongside practical and realistic methods for improving mealtimes; tips for not using food for rewards or for comfort; information on common feeding pitfalls. Caregivers also reported finding the Child Feeding Guide novel, interesting and educational, and easy to use. Conclusions: Preliminary user feedback suggests that the Child Feeding Guide is filling a critical gap in available support resources. Caregivers and health professionals report that it is easy to use, helpful and accessible. While initial user testing of the Child Feeding Guide confirms its value, further formal testing of this resource is required prior to wider-scale roll-out.

Factors Contributing to Infant Overfeeding in Low‐Income Immigrant Hispanic Mothers

Paper Presentation Objective To describe multidimensional factors and maternal feeding practices that may correlate with infant overfeeding in Latina mothers. A secondary aim was to determine whether there was an association between these factors and infant weight. Design A descriptive correlational cross‐sectional study. Setting Participants were recruited through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Sample Sixty‐two low‐income immigrant Latina mothers receiving WIC assistance and their infants age 4 to 12 months. Methods A native Spanish speaking investigator who guided the participants through the options administered all the measures, including acculturation indicators, maternal feeding beliefs, maternal feeding practices, maternal knowledge and self‐efficacy, food availability/insecurity indicators, infant's temperament, infant's 24‐hour dietary recall, and infant's height and weight measures. Univariate and multiple linear regressions were used to examine relationships. Results More than 46% of infants were at >85 th percentile for weight for length; of those, 21% were at >98 th percentile. Among infants at the >85 th percentile for weight for length, 27% of the mothers wished their infants were heavier. Only one mother was breastfeeding exclusively. Almost one third of mothers (24%) preferred supplementing breast milk with formula feeding, and 74% used formula feeding. Healthier maternal feeding practices were inversely correlated with maternal age and the number of people living at home. Multiple regression results showed infant's age and maternal education as significant positive predictors of less controlling maternal feeding practices. None of the analyzed factors were significant predictors of infant weight. Conclusion/Implications for Nursing Practice Future intervention efforts should focus primarily on the promotion of healthy feeding practices that encourage and support exclusive breastfeeding among this ethnic group. A clearer understanding of the socioeconomic and cultural contexts that promote conditions for infants becoming overweight is necessary for developing culturally sensitive screening tools to assess infants at risk and promoting targeted preventive interventions that begin early in life and are meaningful to Latina mothers.

Obesity prevention in early life: an opportunity to better support the role of Maternal and Child Health Nurses in Australia.

BackgroundBecause parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported.MethodsThis mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0–5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles.ResultsAlthough nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation.ConclusionWhile MCH nurses are well placed to address obesity prevention in early life, there is currently a missed public health opportunity. Improving nurse skills in behaviour change counseling will be key to increasing their confidence in raising sensitive lifestyle issues with parents to better integrate obesity prevention practices into normal MCH service delivery.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-015-0077-7) contains supplementary material, which is available to authorized users.

Factors contributing to infant overfeeding in low-income immigrant Latina mothers

BackgroundApproximately 10% of U.S. infants and toddlers are considered overweight. Hispanic infants persistently show higher prevalence rates for being overweight compared to other infants. Little is known about factors promoting excessive infant weight gain in Latinos. PurposeThe aim of this study was to describe multidimensional factors and maternal feeding practices that may correlate with infant overfeeding in Latina mothers. MethodsParticipants were 62 low-income immigrant Latina mothers and their infants. Study measures were: acculturation; maternal feeding beliefs and practices; food availability; temperament; 24-hour dietary recall; and infant's weight-for-height z score. ResultsIn regression models adjusted for infant's age, healthier feeding practices were significantly predicted by maternal education and infant's age. Most mothers preferred feeding their infants either formula or a combination of breast milk and formula. A significant proportion of the infants were overweight or obese and yet some mothers displayed difficulty recognizing this problem. ConclusionFuture intervention efforts should focus primarily on the promotion of healthy feeding practices that discourage overfeeding and support exclusive breastfeeding among this ethnic group.

Clinical impact of human breast milk metabolomics

Metabolomics is a research field concerned with the analysis of metabolome, the complete set of metabolites in a given cell, tissue, or biological sample. Being able to provide a molecular snapshot of biological systems, metabolomics has emerged as a functional methodology in a wide range of research areas such as toxicology, pharmacology, food technology, nutrition, microbial biotechnology, systems biology, and plant biotechnology. In this review, we emphasize the applications of metabolomics in investigating the human breast milk (HBM) metabolome. HBM is the recommended source of nutrition for infants since it contains the optimal balance of nutrients for developing babies, and it provides a range of benefits for growth, immunity, and development. The molecular mechanisms beyond the inter- and intra-variability of HBM that make its composition unique are yet to be well-characterized. Although still in its infancy, the study of HBM metabolome has already proven itself to be of great value in providing insights into this biochemical variability in relation to mother phenotype, diet, disease, and lifestyle. The results of these investigations lay the foundation for further developments useful to identify normal and aberrant biochemical changes as well as to develop strategies to promote healthy infant feeding practices.

Tools for teen moms to reduce infant obesity: a randomized clinical trial.

BackgroundUnhealthy infant feeding practices, such as a combination of formula feeding and early introduction of solids may lead to rapid or excessive weight gain in early infancy. Adolescent mothers’ feeding behaviors are most directly related to infant weight gain in the first year of life. Compared to adult mothers, adolescent mothers are less knowledgeable, less responsive, more controlling, and less skilled in infant feeding, which interferes with infants’ healthy growth. The Tools for Teen Moms trial aims to compare the effect of a social media intervention for low-income adolescent, first-time mothers of infants 2 months of age or younger, versus standard care on infant weight, maternal responsiveness, and feeding style and practices. The intervention is conducted during the infant’s first four months of life to promote healthy transition to solids during their first year. Tools for Teen Moms is an intervention delivered via a social media platform that actively engages and coaches low-income adolescent mothers in infant-centered feeding to reduce rapid/excessive infant weight gain in the first six months of life.Methods/DesignWe describe our study protocol for a randomized control trial with an anticipated sample of 100 low-income African- American and Caucasian adolescent, first–time mothers of infants. Participants are recruited through Maternal-Infant Health Programs in four counties in Michigan, USA. Participants are randomly assigned to the intervention or the control group. The intervention provides infant feeding information to mothers via a web-based application, and includes daily behavioral challenges, text message reminders, discussion forums, and website information as a comprehensive social media strategy over 6 weeks. Participants continue to receive usual care during the intervention. Main maternal outcomes include: (a) maternal responsiveness, (b) feeding style, and (c) feeding practices. The primary infant outcome is infant weight. Data collection occurs at baseline, and when the baby is 3 and 6 months old.DiscussionExpected outcomes will address the effectiveness of the social media intervention in helping teen mothers develop healthy infant feeding practices that contribute to reducing the risk of early onset childhood obesity.Trial registrationClinical Trials.Gov NCT02244424, June 24, 2014