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Theurich MA, Ziebart M, Strobl F. National survey of infant feeding bottles in Germany: Their characteristics and marketing claims. MATERNAL & CHILD NUTRITION 2024; 20:e13632. [PMID: 38385989 PMCID: PMC11168357 DOI: 10.1111/mcn.13632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/06/2024] [Accepted: 01/23/2024] [Indexed: 02/23/2024]
Abstract
Bottles and teats are ubiquitously used for feeding infants and young children. Yet there are limited empirical studies on the scope of infant feeding bottles, their attributes, or their marketing claims. We report the first comprehensive survey on infant feeding bottles and teats in Germany. We aimed to explore the extent of bottles and teats available in Germany, describe their physical attributes and analyze their marketing claims. A cross-sectional survey of German bottle and teat manufacturer websites was conducted between June and November 2022. Product attributes are presented with descriptive statistics and photographs. Marketing claims are summarized in a descriptive content analysis. We identified 41 brands encompassing 447 unique products (226 bottles, 221 teats). The majority of bottles were plastic (147, 65%) or glass (64, 28%), and the majority of teats were silicone (188, 85%). Most brands (38, 93%) promoted products using one or more inappropriate marketing claims, including equivalency to breastfeeding (29, 73%), idealization through technical or medical descriptions (23, 58%), claims on disease prevention (31, 78%), references to naturalness (29, 73%), infant autonomy (10, 25%), and endorsements from parents (10, 25%) or health professionals (11, 28%). The majority of bottles and teats available in Germany appear to be marketed inappropriately and hold the potential to undermine public health recommendations on infant and young child feeding. Therefore, we recommend Germany strengthens legislation on the marketing of bottles and teats in accordance with the International Code of Marketing of Breastmilk Substitutes.
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Affiliation(s)
- Melissa A. Theurich
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Faculty of MedicineLMU—Ludwig‐Maximilians‐Universität MünchenMunichGermany
| | | | - Frances Strobl
- School of Life SciencesTechnische Universität MünchenMunichGermany
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Ortega-Ramírez AD, Murillo-Zamora E, Trujillo-Hernández B, Delgado-Enciso I, Sánchez-Ramírez CA. Birth weight, slowness in eating and feeding practices as independent determinants of rapid weight gain. Acta Paediatr 2024. [PMID: 38922980 DOI: 10.1111/apa.17330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
AIM Our aim was to identify independent determinants of rapid weight gain in infants at 3-4, 6, and 12 months of age. METHODS A cohort study was conducted on Mexican term infants in public and private settings between March 2021 and May 2023. Rapid weight gain was defined as a ≥0.67 SD change in weight-for-age-Z-score from birth to 3-4, 6, and 12 months of age. Maternal and infant characteristics were described, and infant feeding practices, appetitive traits, weight, and length were analysed at 3-4, 6, and 12 months of age. Rapid weight gain predictors were determined using generalised linear regression models. RESULTS In total, 168 infants were recruited (55% boys). Small-for-gestational-age status increased rapid weight gain risk 1.5 times, whereas large-for-gestational-age status represented a 20%-30% decrease. Slowness in eating decreased the risk by 10%. Protective factors were older maternal age and higher educational level, whereas formula feeding, early complementary feeding, greater food enjoyment, and satiety responsiveness increased the risk. CONCLUSIONS Small for gestational age, slowness in eating, and feeding practices can be rapid weight gain predictors across the first year of life.
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Affiliation(s)
| | - Efrén Murillo-Zamora
- Faculty of Medicine, University of Colima, Colima, Mexico
- Clinical Epidiemiology Research Unit, Mexican Institute of Social Security, Villa de Álvarez, Colima, Mexico
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Limauro R, Cioffi L, Bianco V, Caruso V, Casani A, Del Gaizo D, Esposito A, Farris E, Gallo P, Giuliano M, Iannone A, Izzo A, La Vecchia MT, Raineri L, Sabetti P, Sassi R, Servodidio C, Sorice N, Cioffi V, Antignani A, Valerio G. Nutritional counselling and risk factors for obesity: an observational study in toddlers. Ital J Pediatr 2024; 50:115. [PMID: 38872179 PMCID: PMC11170809 DOI: 10.1186/s13052-024-01668-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 04/28/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Nutrition exerts a fundamental role in the prevention of obesity (OB). The aim of this study was to assess the extent to which well recognized risk factors for early OB can be associated to overweight (OW) or OB under a standardized nutritional approach and surveillance in toddlers. METHODS The eligible population was represented by 676 toddlers aged 24-36 months, assigned to 18 primary care pediatricians trained on nutritional issues who shared a standardized nutritional approach. Six-hundred-twenty-nine children (333 boys), mean age 27.8 ± 4.2 months were effectively included in this observational study. Parents received nutritional advice with particular emphasis to proteins and sugar composition supported by leaflets and reinforced at each visit. Body mass index was assessed at the age of 24-36 months. The following individual and family risk factors were considered: gestational age, birth weight, eutocic/caesarean delivery, milk feeding history, household smoking or antibiotics exposure, parents' weight, height and educational level. Prevalence of OW/OB was compared to a group of 742 toddlers (373 boys) under usual care. RESULTS Under a standardized nutritional counselling, 28.1% toddlers were classified as OW/OB compared to 36.9% toddlers under usual care (p = 0.005). In unadjusted models, parental OW/OB was significantly associated to OW/OB in toddlers (p < 0.01), while high birth weight did not reach statistical significance (p = 0.07). In adjusted models, including all the explanatory variables studied, only paternal OW/OB vs. normal weight was significantly associated to OW/OB in toddlers (OR 2.035, 95% confidence interval 1.206-3.436). No protective effect of exclusive breast feeding during the first 6 months of age was demonstrated. CONCLUSIONS Toddlers under a standardized nutrition counselling focused to limit protein and simple sugars, showed lower prevalence of OW/OB compared to usual care. Healthy promotion activities should take into account the influence of paternal BMI on the offspring adiposity.
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Affiliation(s)
- Raffaele Limauro
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Luigi Cioffi
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Vincenzo Bianco
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Vincenzo Caruso
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | - Antonella Casani
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | | | - Aldo Esposito
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Evelina Farris
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Patrizia Gallo
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Maria Giuliano
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Agnese Iannone
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Annamaria Izzo
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | | | - Luca Raineri
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Patrizia Sabetti
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | - Roberto Sassi
- Italian Federation of Pediatricians Study Center, Naples, 80100, Italy
| | | | - Nunziatina Sorice
- Benevento Section, Italian Federation of Pediatricians, Benevento, 82010, Italy
| | - Valentina Cioffi
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, 80131, Italy
| | | | - Giuliana Valerio
- Department of Medical, Movement and Wellbeing Sciences, University of Naples Parthenope, Naples, 80133, Italy.
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Michalopoulou S, Sifaki M, Packer J, Lanigan J, Stansfield C, Viner RM, Russell S. Assessing the impact of obesity interventions in the early years: a systematic review of UK-based studies. BMJ Open 2024; 14:e076479. [PMID: 38740507 PMCID: PMC11097867 DOI: 10.1136/bmjopen-2023-076479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 02/13/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES Childhood obesity rates in the UK are high. The early years of childhood are critical for establishing healthy behaviours and offer interventional opportunities. We aimed to identify studies evaluating the impact of UK-based obesity interventions in early childhood. DESIGN Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Nine databases were searched in March 2023. ELIGIBILITY CRITERIA We included UK-based obesity intervention studies delivered to children aged 6 months to 5 years that had diet and/or physical activity components and reported anthropometric outcomes. The primary outcome of interest was z-score Body Mass Index (zBMI) change (within and between subjects). Studies evaluating the effects of breastfeeding interventions were not included as obesity prevention interventions, given that best-practice formula feeding is also likely to encourage healthy growth. The publication date for studies was limited to the previous 12 years (2011-23), as earlier reviews found few evaluations of interventions in the UK. DATA EXTRACTION AND SYNTHESIS The reviewers worked independently using standardised approach to search, screen and code the included studies. Risk of bias was assessed using Cochrane tools (ROB 2 or ROBINS-I). RESULTS Six trials (five studies) were identified, including two randomised controlled trials (RCT), one cluster randomised trial (CRT), two feasibility CRTs and one impact assessment. The total number of participants was 566. Three trials focused on disadvantaged families and two included high-risk children categorised as having overweight or obesity. Compared with baseline, five interventions reported reductions in zBMI, three of which were statistically significant (p<0.05). Compared with control, five interventions showed zBMI reductions, one of which was significant. Only two trials were followed up beyond 12 months. All studies were found to have a high risk of bias. Meta-analysis was not possible due to the heterogeneity of studies. CONCLUSION UK evidence was limited but some interventions showed promising results in promoting healthy growth. As part of a programme of policies, interventions in the early years may have an important role in reducing the risk of childhood obesity. PROSPERO REGISTRATION NUMBER CRD42021290676.
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Affiliation(s)
- Semina Michalopoulou
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Maria Sifaki
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Jessica Packer
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Julie Lanigan
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | | | - Russell M Viner
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Simon Russell
- Great Ormond Street Institute of Child Health, University College London, London, UK
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Dharod JM, Labban JD, Tadese H, Flax VL, Black MM, Ammerman AS. Cyclic Formula Feeding Among Infants Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Nutr 2024:S0022-3166(24)00278-5. [PMID: 38740186 DOI: 10.1016/j.tjnut.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/15/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Low-income households often experience a cyclic pattern in food availability, with acute food shortages at month end. Variations in the monthly feeding of infant formula are understudied. OBJECTIVES This study aimed to compare the amount and frequency of formula consumed at the beginning and end of the monthly Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) assistance cycle and test associations with total energy intake and other feeding practices among infants aged 7-11 mo. METHODS This study was conducted between May 2020 and April 2021 in the southeastern United States and involved mothers of infants participating in WIC's fully formula package. Mothers were interviewed and 24-h feeding recalls were conducted at the beginning and end of the month. We defined month beginning as 5 d following the first WIC formula purchase and month end as 5 d before the next monthly cycle. Fifty mother-infant dyads participated in single or multiple monthly cycles, totaling 98 monthly cycles. Generalized linear mixed-effects modeling was used to test differences in formula feeding at month beginning and end. RESULTS Most participants (84%) were African American or Latino and >90% purchased all formula within 2-3 d of the WIC issuance. The energy intake from formula at month beginning was significantly higher than at month end (67.63% and 57.85%, respectively; P = 0.002), with no differences in total energy intake. The odds of infants being fed cow milk and fruit juices/drinks increased from month beginning to end (P < 0.05). CONCLUSIONS Infants in low-income households are at risk of experiencing a cyclic feeding pattern characterized by higher formula feeding at month beginning and an increase in feeding of nonrecommended drinks at month end. The WIC program policy could review educational and distribution options to reduce cyclic formula feeding and clarify caregivers' understanding of infants' formula needs. Household-level investigations into formula management and determinants of cyclic feeding are warranted.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, United States.
| | - Jeffrey D Labban
- Office of Research in the School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Helen Tadese
- Office of Research in the School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Valerie L Flax
- RTI International, Research Triangle Park, NC, United States
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, United States; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Neve KL, Coleman P, Hawkes C, Vogel C, Isaacs A. What shapes parental feeding decisions over the first 18 months of parenting: Insights into drivers towards commercial and home-prepared foods among different socioeconomic groups in the UK. Appetite 2024; 196:107260. [PMID: 38403201 DOI: 10.1016/j.appet.2024.107260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024]
Abstract
Infants born into families experiencing socioeconomic disadvantage follow a high-risk trajectory for obesity and poor health in later life. Differences in early childhood food experiences may be contributing to these inequalities. This study aimed to explore the factors that influence parental decisions on when, how and what food to introduce over the first 18 months of their child's life and identify differences according to families' social position. Particular attention was given to social and environmental determinants within and outside the home. This research utilised a longitudinal qualitative methodology, with interviews and photo-elicitation exercises completed by participants when their children were 4-6; 10-12 and 16-18 months of age. Participants were parents (61 mothers; 1 father), distributed across low, medium and high socioeconomic position (SEP). During analysis, observable differences in factors directing parents to home-prepared or commercial foods were identified. Factors that undermined the provision of home-prepared meals included lack of time after returning to work, insufficient support from partners, uncertainty around infant and young child feeding (defined as the introduction and provision of solids) and an implicit trust in the messaging on branded products. These factors directed parents towards commercial foods and were most persistent among families experiencing socioeconomic disadvantage due to barriers accessing formal childcare, less flexible working conditions and fathers being less involved in infant feeding. To facilitate an enabling environment for healthy infant and young child feeding practices and address dietary inequalities, immediate steps that policy makers and healthcare providers can take include: i) changing the eligibility criteria for shared parental leave, ii) aligning claims on commercial infant food labels with international best practices, and iii) improving access to formal childcare.
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Affiliation(s)
- Kimberley L Neve
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK.
| | - Paul Coleman
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Corinna Hawkes
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Christina Vogel
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
| | - Anna Isaacs
- Centre for Food Policy, City University of London, Northampton Square, London, EC1V 0HB, UK
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Richardson TN, Reis P, Swanson M. Mental Health and Feeding Styles in Parents of Formula-Fed Infants. Child Obes 2024; 20:178-187. [PMID: 37130301 PMCID: PMC10979682 DOI: 10.1089/chi.2022.0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background: Nonresponsive feeding styles can contribute to rapid weight gain in infancy and subsequent obesity in childhood. There is a need to investigate factors such as parental mental health symptoms (stress, depression, and anxiety) that may contribute to nonresponsive feeding styles. The purpose of this study was to investigate the relationship between parental mental health symptoms and feeding styles in parents of healthy, term formula-fed infants during the first year of life. Methods: A cross-sectional, descriptive correlational design was employed using online surveys. We recruited participants through Facebook groups and pediatricians' offices. Instruments included a demographic questionnaire, the Perceived Stress Scale-10, Patient Health Questionnaire-Depression Module-9, 7-item Generalized Anxiety Disorder Assessment, and Infant Feeding Style Questionnaire. Results: Participants were 306 parents of formula-fed infants. Greater depressive symptoms was the strongest predictor of the pressuring style (β = 0.54), while greater symptoms of stress (β = -0.13) and anxiety (β = -0.28) were associated with lower pressuring scores. Greater depressive symptoms was the strongest predictor of the laissez-faire style (β = 0.48), while greater symptoms of stress (β = -0.17) and anxiety (β = -0.23) were associated with lower laissez-faire scores. Engaging in ≤50% of the infant's feeds was the strongest control variable predictor for the pressuring and laissez-faire styles. None of the mental health variables were significantly related to the restrictive style. Conclusions: We recommend increased screening for depressive symptoms in parents of infants and responsive feeding support, especially for those experiencing depressive symptoms.
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Affiliation(s)
| | - Pamela Reis
- College of Nursing, East Carolina University, Greenville, NC, USA
| | - Mel Swanson
- College of Nursing, East Carolina University, Greenville, NC, USA
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Yoong SL, Turon H, Wong CK, Grady A, Pearson N, Sutherland R. A rapid review of the scalability of interventions targeting obesity prevention in infants. Health Promot J Austr 2024; 35:365-370. [PMID: 37343544 DOI: 10.1002/hpja.760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 05/24/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023] Open
Abstract
ISSUE ADDRESSED Obesity in children is one of the most significant public health issues globally. Given the high prevalence of overweight and obesity in children, there is a need to identify effective obesity prevention efforts that can be delivered at scale to improve child health. We aimed to (i) identify obesity prevention interventions targeted at children aged 0-2 that have been scaled-up, and their relative efficacy compared to their pre-scale trial, (ii) describe adaptations made, and the extent to which factors related to scalability have been reported. METHODS We conducted a rapid review of pre-scale randomised controlled trials targeting nutrition, physical activity and obesity prevention in infants, and calculated the relative effect size for relevant outcomes in the corresponding scaled up trial. We documented adaptations made to the pre-scale trial for scale up, and explored how different components of scalability had been reported according to the Intervention Scalability Assessment Tool. RESULTS Of the 14 identified pre-scale trials, only one formal evaluation of the scale-up trial was identified. For body mass index, <10% of the effect was retained, however for nutrition and behavioural outcomes, the proportion of effect retained varied from -11.1% to 144%. Significant adaptations to modality were made in the scaled up trial primarily to reduce cost and increase reach of the intervention. Reporting of scalability components varied across the 14 trials, with only one trial reporting information for all assessed components. CONCLUSIONS The majority of effective interventions targeting obesity prevention in infants have not been evaluated in a scaled up form. The magnitude of effect retained for the single trial that was scaled up was variable. In general, reporting of components of scalability was sub-optimal. SO WHAT?: The findings suggest that there is substantial need for the development and rigorous evaluation of obesity prevention interventions in children aged 0-2 which are amenable for scale.
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Affiliation(s)
- Sze Lin Yoong
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, Australia
| | - Heidi Turon
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, Australia
| | - Carrie K Wong
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Alice Grady
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, Australia
| | - Nicole Pearson
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, Australia
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Slater CN, Juntereal NA, Kral TVE, Spatz DL, Chao AM. Comparison of the Effect of Direct Breastfeeding, Expressed Human Milk, and Infant Formula Feeding on Infant Weight Trajectories: A Systematic Review. Breastfeed Med 2024; 19:235-247. [PMID: 38497755 DOI: 10.1089/bfm.2023.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Background: Formula and breastfeeding are known factors associated with infant weight trajectories. Evidence exploring the effect of expressed human milk feeding on infant weight in the community setting has not been well synthesized. Objectives: This systematic review examined (1) weight changes among infants fed expressed human milk and (2) differences in weight change between infants fed expressed human milk and infants fed at the breast or infant formula via bottle. Methods: A comprehensive search of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of each study was appraised using the Joanna Briggs Critical Appraisal Tools. Results: A total of six studies met the eligibility criteria and included a total of 5,152 infants. The within-subject analysis identified only 31 infants strictly or predominantly fed expressed human milk. The between-subject analysis comparing expressed human milk feeding to the available comparison groups (formula-fed or direct at the breastfed) revealed that higher weight gains were observed in the weight trajectories among infants in the bottle or formula-fed conditions in four of the six included studies. Conclusions: Findings from the few studies included in this review found a difference in the infant weight gain patterns among expressed human milk-fed infants when compared with their respective feeding groups (directly breastfed or formula-fed). Further research is needed to corroborate these findings and elucidate the clinical significance of the differences in weight gain patterns observed across infant feeding groups.
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Affiliation(s)
- Courtney N Slater
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Nina A Juntereal
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Tanja V E Kral
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Diane L Spatz
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Center for Pediatric Nursing Research & Evidence-Based Practice, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ariana M Chao
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
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Bell L, Manson A, Zarnowiecki D, Tan SN, Byrne R, Taylor R, Zheng M, Wen LM, Golley R. Development and validation of a short dietary questionnaire for assessing obesity-related dietary behaviours in young children. MATERNAL & CHILD NUTRITION 2024; 20:e13613. [PMID: 38192050 PMCID: PMC10981485 DOI: 10.1111/mcn.13613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/07/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024]
Abstract
There are few short, validated tools to assess young children's obesity-related dietary behaviours, limiting the rapid screening of dietary behaviours in research and practice-based early obesity prevention. This study aimed to develop and assess the reliability and validity of a caregiver-reported short dietary questionnaire to rapidly assess obesity-related dietary behaviours in children aged 6 months to 5 years. The Early Prevention of Obesity in Childhood Dietary Questionnaire (EPOCH-DQ) was developed using a rigorous process to determine content and structural validity. Three age-appropriate versions were developed for (1) infants, aged 6-12 months, (2) toddlers, aged 1-2.9 years and (3) pre-schoolers, aged 3-5 years. The questionnaire (7-15 items) measures dietary behaviours, including diet risk from non-core food and beverage intake, diet quality from vegetable frequency, bread type and infant feeding practices. Test-retest reliability was assessed from repeated administrations 1 week apart (n = 126). Internal consistency, concurrent validity (against a comparison questionnaire, the InFANT Food Frequency Questionnaire), construct validity and interpretability were assessed (n = 209). Most scores were highly correlated and significantly associated (p < 0.05) for validity (rs: 0.45-0.89, percentage agreement 68%-100%) and reliability (intraclass correlation coefficient: 0.61-0.99) for diet risk, diet quality and feeding practice items. The EPOCH-DQ shows acceptable validity and reliability for screening of obesity-related behaviours of children under 5 years of age. The short length and, thus, low participant burden of the EPOCH-DQ allows for potential applications in various settings. Future testing of the EPOCH-DQ should evaluate culturally and socio-economically diverse populations and establish the predictive validity and sensitivity to detect change.
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Affiliation(s)
- Lucinda Bell
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Alexandra Manson
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Dorota Zarnowiecki
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Shi Ning Tan
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Rachael Taylor
- Department of MedicineUniversity of OtagoDunedinNew Zealand
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesDeakin UniversityGeelongVictoriaAustralia
| | - Li Ming Wen
- Sydney School of Public Health, Faculty of Medicine and HealthSydneyNew South WalesAustralia
| | - Rebecca Golley
- Flinders University, College of Nursing and Health Sciences, Caring Futures InstituteAdelaideSouth AustraliaAustralia
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Dharod JM, Black MM, McElhenny K, Labban JD, DeJesus JM. Es Niño o Niña?: Gender Differences in Feeding Practices and Obesity Risk among Latino Infants. Curr Dev Nutr 2024; 8:102100. [PMID: 38425439 PMCID: PMC10904161 DOI: 10.1016/j.cdnut.2024.102100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
Background Obesity prevalence is significantly higher among Latino boys than girls. Weight status at 12 mo, a significant predictor of childhood obesity, is associated with feeding practices during infancy. Objectives The objectives were to examine breastfeeding and formula-feeding practices overall and by infant gender and to examine relations among infant gender, milk-feeding practices, and obesity risk among Latino infants over the first year of life. Methods Latino mother-infant dyads (n = 90) were recruited from a pediatric clinic. Mothers were interviewed at regular intervals (infants aged 2, 4, 6, and 9 mo), and 24-h feeding recalls were conducted when infants were aged 6 and 9 mo. Infants' lengths and weights were retrieved from clinic records to calculate weight-for-length percentiles. A bivariate analysis was conducted to compare feeding practices by gender and mediation analysis to test whether feeding practices mediated the relation between gender and obesity risk. Results The majority (80%) of mothers were born outside the United States. In early infancy, mixed feeding of formula and breastfeeding was common. At 6 and 9 mo of age, milk-feeding practices differed, with formula feeding more common for boys than girls. At 12 mo, 38% of infants experienced obesity risk (≥85th weight-for-length percentile). Infants' obesity risk increased by 18% per 1 oz increase in powdered formula intake. Formula intake among boys was on average 1.42 oz (in dry weight) higher than that among girls, which, in turn, mediated their increased obesity risk (IERR = 1.27, 95% confidence interval: 1.02, 1.90). Conclusions The increased obesity risk among Latino boys compared with girls at 12 mo was explained by higher rates of formula feeding at 6 and 9 mo of age. Future investigations of cultural values and beliefs in gender-related feeding practices are warranted to understand the differences in obesity risk between Latino boys and girls.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, United States
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kristen McElhenny
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jeffrey D Labban
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jasmine M DeJesus
- Department of Psychology, College of Arts and Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
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12
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Petersohn I, Hellinga AH, van Lee L, Keukens N, Bont L, Hettinga KA, Feskens EJM, Brouwer-Brolsma EM. Maternal diet and human milk composition: an updated systematic review. Front Nutr 2024; 10:1320560. [PMID: 38352250 PMCID: PMC10862141 DOI: 10.3389/fnut.2023.1320560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
Context Exclusive breastfeeding for 6 months after birth provides infants with the best start for life. A review by Bravi et al. summarized the importance of maternal diet as a determinant of human milk composition based on data up to 2015, but evidence on nutrient intake level was limited. Objective We updated the review by Bravi et al., critically assessed differences in study designs and sampling methods, and graphically visualized trends and associations. Data sources PubMed was systematically searched for articles published between January 2015 and March 2021. Data extraction Article screening, selection, and data extraction was done by two independent researchers, including a risk of bias assessment based on 11 criteria. Articles were eligible when including: quantitative information, commonly used effect estimates, healthy mother-infant dyads. Results Twenty seven observational and five intervention studies were identified (n = 7,138) and combined with results of Bravi et al. Fatty acids were still the most studied human milk components in relation to maternal diet (n = 17 studies) with maternal fish intake being predominantly positively associated with milk ALA (r = 0.28-0.42), DHA (r = 0.24-0.46), and EPA (r = 0.25-0.28) content. PUFAs from diet were generally positively correlated with their concentrations in milk, while SFA intake was negatively associated with several fatty acids in milk. Studies on associations with maternal diet and milk carbohydrates, proteins, vitamins and minerals were limited in number and varied in methods and results. Conclusion This updated review shows that evidence on the association between maternal diet and human milk fatty acids is rapidly increasing, but still diversified in methodology and results. Further studies, preferably intervention studies, assessing diet and milk carbohydrates, proteins, vitamins and minerals are needed to be able draw conclusions on the importance of maternal diet for human milk composition as a whole.
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Affiliation(s)
- Inga Petersohn
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
- Ausnutria BV, Zwolle, Netherlands
| | - Anneke H. Hellinga
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Nicole Keukens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Louis Bont
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
- ReSViNET Foundation, Zeist, Netherlands
| | - Kasper A. Hettinga
- Division of Food Quality and Design, Wageningen University and Research, Wageningen, Netherlands
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Elske M. Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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13
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Dharod JM, Frazier CM, Labban J, Black MM. Breastfeeding duration and associations with prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds. Public Health Nutr 2023; 27:e6. [PMID: 38047374 PMCID: PMC10830380 DOI: 10.1017/s1368980023002689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/30/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To describe breastfeeding rates from early to late infancy and to examine associations between breastfeeding duration and infant growth, including rapid weight gain (RWG, > 0·67 SD increase in weight-for-age Z-score), among infants from low-income, racially and ethnically diverse backgrounds. DESIGN A short, prospective cohort study was conducted assessing breastfeeding status at infant ages 2, 4, 6, 9 and 12 months. Infant length and weight measurements were retrieved from electronic health records to calculate weight-for-length Z-scores and the rate of weight gain. SETTING Pediatric clinic in the Southeastern USA. PARTICIPANTS Mother-infant dyads (n = 256). RESULTS Most participants were African American (48 %) or Latina (34 %). Eighty-one per cent were participating in the Special Supplemental Nutrition Program for Women, Infants and Children. Infants were breastfed for a median duration of 4·75 months, with partial more common than exclusive breastfeeding. At 12 months, 28 % of the participants were breastfeeding. Infants breastfed beyond 6 months had significantly lower growth trajectories than infants breastfed for 0-2 months (β = 0·045, se = 0·013, P = 0·001) or 3-6 months (β = 0·054, se = 0·016, P = 0·001). Thirty-six per cent of the infants experienced RWG. RWG was more common among infants who were breastfed for 2 months or less than 6+ month breastfed group (relative risk = 1·68, CI95 (1·03, 2·74), P = 0·03). CONCLUSIONS Breastfeeding beyond 6 months is associated with the prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds, suggesting progress toward health equity.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, 319 College Avenue, University of North Carolina at Greensboro, Greensboro, NC27412, USA
| | - Christina M Frazier
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | - Maureen M Black
- Department of Pediatrics, University of Maryland, School of Medicine, Baltimore, MD, USA
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14
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Esfarjani SV, Alaei S, Saki A. Breastfeeding pattern and its relationship with weight gain in children older than 6 months. J Family Med Prim Care 2023; 12:3249-3253. [PMID: 38361836 PMCID: PMC10866249 DOI: 10.4103/jfmpc.jfmpc_694_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/14/2023] [Accepted: 08/01/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction According to the World Health Organization (WHO), breastfeeding is the best way to feed infants. Adoption of some inappropriate nutritional patterns along with breast milk, especially in infants older than 6 months, may lead to a delay in the child's growth. Therefore, the present study was conducted to investigate the relationship between breastfeeding and weight gain in children aged 6-24 months. Materials and Methods This case-control study was conducted on 120 infants aged 6-24 months and their mothers recruited from health centers of Ahvaz, southwest of Iran. The data collection tool in the present study included a questionnaire to record demographic information and information in the child's medical records in health centers. Statistical analysis of the data was done by SPSS 23 using the Chi-square test and t-test. Results No significant difference was observed between the control and case groups in terms of the infant's age (P = 0.741) and gender (P = 0.564) and the mothers' age (P = 0.614), her educational attainment (P = 0.389), and socioeconomic status of the infant's family (P = 0.563). The type of delivery (P = 0.650), mothers' opinion (P = 0.133), and the interval between breastfeeding and complementary feeding (P = 0.144) had no significant relationship with the infant's growth disorder. On the other hand, duration of breastfeeding per meal (P = 0.007) and frequent breastfeeding (dependency on the mother's breast) (P = 0.049) had a significant relationship with children's developmental disorders. Conclusion According to the results of the present study, growth disorders in infants in the case group could be attributed to their mothers' inappropriate breastfeeding patterns.
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Affiliation(s)
- Shahla V. Esfarjani
- Department of Community Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeid Alaei
- Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Saki
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Gonzalez-Garay AG, Serralde-Zúñiga AE, Medina Vera I, Velasco Hidalgo L, Alonso Ocaña MV. Higher versus lower protein intake in formula-fed term infants. Cochrane Database Syst Rev 2023; 11:CD013758. [PMID: 37929831 PMCID: PMC10626736 DOI: 10.1002/14651858.cd013758.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Many infants are fed infant formulas to promote growth. Some formulas have a high protein content (≥ 2.5 g per 100 kcal) to accelerate weight gain during the first year of life. The risk-benefit balance of these formulas is unclear. OBJECTIVES To evaluate the benefits and harms of higher protein intake versus lower protein intake in healthy, formula-fed term infants. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, OpenGrey, clinical trial registries, and conference proceedings in October 2022. SELECTION CRITERIA We included randomized controlled trials (RCTs) of healthy formula-fed infants (those fed only formula and those given formula as a complementary food). We included infants of any sex or ethnicity who were fed infant formula for at least three consecutive months at any time from birth. We excluded quasi-randomized trials, observational studies, and infants with congenital malformations or serious underlying diseases. We defined high protein content as 2.5 g or more per 100 kcal, and low protein content as less than 1.8 g per 100 kcal (for exclusive formula feeding) or less than 1.7 g per 100 kcal (for complementary formula feeding). DATA COLLECTION AND ANALYSIS Four review authors independently assessed the risk of bias and extracted data from trials, and a fifth review author resolved discrepancies. We performed random-effects meta-analyses, calculating risk ratios (RRs) or Peto odds ratios (Peto ORs) with 95% confidence intervals (CIs) for dichotomous outcomes, and mean differences (MDs) with 95% CIs for continuous outcomes. We used the GRADE approach to evaluate the certainty of the evidence. MAIN RESULTS We included 11 RCTs (1185 infants) conducted in high-income countries. Seven trials (1629 infants) compared high-protein formula against standard-protein formula, and four trials (256 infants) compared standard-protein formula against low-protein formula. The longest follow-up was 11 years. High-protein formula versus standard-protein formula We found very low-certainty evidence that feeding healthy term infants high-protein formula compared to standard-protein formula has little or no effect on underweight (MD in weight-for-age z-score 0.05 SDs, 95% CI -0.09 to 0.19; P = 0.51, I2 = 61%; 7 studies, 1629 participants), stunting (MD in height-for-age z-score 0.15 SDs, 95% CI -0.05 to 0.35; P = 0.14, I2 = 73%; 7 studies, 1629 participants), and wasting (MD in weight-for-height z-score -0.12 SDs, 95% CI -0.31 to 0.07; P = 0.20, I2 = 94%; 7 studies, 1629 participants) in the first year of life. We found very low-certainty evidence that feeding healthy infants high-protein formula compared to standard-protein formula has little or no effect on the occurrence of overweight (RR 1.26, 95% CI 0.63 to 2.51; P = 0.51; 1 study, 1090 participants) or obesity (RR 1.96, 95% CI 0.59 to 6.48; P = 0.27; 1 study, 1090 participants) at five years of follow-up. No studies reported all-cause mortality. Feeding healthy infants high-protein formula compared to standard-protein formula may have little or no effect on the occurrence of adverse events such as diarrhea, vomiting, or milk hypersensitivity (RR 0.93, 95% CI 0.76 to 1.13; P = 0.44, I2 = 0%; 4 studies, 445 participants; low-certainty evidence) in the first year of life. Standard-protein formula versus low-protein formula We found very low-certainty evidence that feeding healthy infants standard-protein formula compared to low-protein formula has little or no effect on underweight (MD in weight-for-age z-score 0.0, 95% CI -0.43 to 0.43; P = 0.99, I2 = 81%; 4 studies, 256 participants), stunting (MD in height-for-age z-score -0.01, 95% CI -0.36 to 0.35; P = 0.96, I2 = 73%; 4 studies, 256 participants), and wasting (MD in weight-for-height z-score 0.13, 95% CI -0.29 to 0.56; P = 0.54, I2 = 95%; 4 studies, 256 participants) in the first year of life. No studies reported overweight, obesity, or all-cause mortality. Feeding healthy infants standard-protein formula compared to low-protein formula may have little or no effect on the occurrence of adverse events such as diarrhea, vomiting, or milk hypersensitivity (Peto OR 1.55, 95% CI 0.70 to 3.40; P = 0.28, I2 = 0%; 2 studies, 206 participants; low-certainty evidence) in the first four months of life. AUTHORS' CONCLUSIONS We are unsure if feeding healthy infants high-protein formula compared to standard-protein formula has an effect on undernutrition, overweight, or obesity. There may be little or no difference in the risk of adverse effects between infants fed with high-protein formula versus those fed with standard-protein formula. We are unsure if feeding healthy infants standard-protein formula compared to low-protein formula has any effect on undernutrition. There may be little or no difference in the risk of adverse effects between infants fed with standard-protein formula versus those fed with low-protein formula. The findings of six ongoing studies and two studies awaiting classification studies may change the conclusions of this review.
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Affiliation(s)
| | - Aurora E Serralde-Zúñiga
- Clinical Nutrition Unit, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Isabel Medina Vera
- Methodology Research Unit, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | - Mathy Victoria Alonso Ocaña
- Clinical Nutrition Unit, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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16
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Ventura AK, Drewelow VM. Knowledge and Use of Paced Bottle-Feeding Among Mothers of Young Infants. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:796-802. [PMID: 37737815 DOI: 10.1016/j.jneb.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/01/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To describe mothers' awareness and use of paced bottle-feeding (PBF) and to investigate whether the use of PBF was associated with maternal characteristics and infant feeding practices. METHODS Cross-sectional, online survey. Participants were mothers of infants < 12 months of age (n = 197). Participants self-reported their awareness and use of PBF, demographic characteristics, and infant feeding practices. RESULTS Of the 41% of participants who indicated they had or maybe had heard of PBF, 23% used PBF and 35% sometimes used PBF. Use of PBF was not associated with mother or infant characteristics. Participants who used PBF were significantly less likely to encourage their infant to finish the bottle (odds ratio, 0.04; 95% confidence interval, 0.01-0.79). CONCLUSIONS AND IMPLICATIONS Paced bottle-feeding was associated with lower likelihood of one dimension of pressuring feeding practices, encouraging infant bottle-emptying. More research is needed to determine the effectiveness of PBF in promoting healthy feeding outcomes.
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Affiliation(s)
- Alison K Ventura
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA.
| | - Vivian M Drewelow
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
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17
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Güneş AO, Karadağ N, Karatekin G. The Effect of Breastfeeding Self-Efficacy on Infants' Weights and Breastfeeding Outcomes. Turk Arch Pediatr 2023; 58:588-593. [PMID: 37737229 PMCID: PMC10724744 DOI: 10.5152/turkarchpediatr.2023.23113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/25/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of breastfeeding self-efficacy (BSE) and breastfeeding success (BFS) on infants' weight gain rates and breastfeeding outcomes. MATERIALS AND METHODS Mothers were evaluated within the postpartum 72 hours with "Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF)" and "LATCH Scale." After 6 months, the mothers were called to learn the exclusive breastfeeding (EB) duration and the weight of the infants. RESULTS Two hundred mother-infant couples were enrolled, 176 (88%) of them could be reached in the sixth month. The BSES-SF scores were positively correlated with LATCH scores (P = .0001). The EB rate in the sixth month was positively correlated with BFS but not correlated with BSE (r, P = .218, .004; .79, .297, respectively). The percentage of weight gain and the rate of weight percentile change of babies according to birth weight at the sixth month of age were negatively correlated with BSE (r = -0.226, -0.148, P = .003, .049, respectively) but not correlated with BFS. CONCLUSION Higher BFS was associated with increased duration of EB in the first 6 months of life, and higher BSE was related to lower increase in the percentage of weight gain and a lower rate of weight percentile change of babies at 6 months of age.
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Affiliation(s)
- Aslı Okbay Güneş
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Turkey
| | - Nilgün Karadağ
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Turkey
| | - Güner Karatekin
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Turkey
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18
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Kian N, Bagheri A, Salmanpour F, Soltani A, Mohajer Z, Samieefar N, Barekatain B, Kelishadi R. Breast feeding, obesity, and asthma association: clinical and molecular views. Clin Mol Allergy 2023; 21:8. [PMID: 37789370 PMCID: PMC10546753 DOI: 10.1186/s12948-023-00189-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023] Open
Abstract
Asthma is a chronic condition that affects children worldwide. Accumulating number of studies reported that the prevalence of pediatric obesity and asthma might be altered through breastfeeding. It has been proposed that Leptin, which exists in human milk, is oppositely associated with weight increase in newborns. It may also influence peripheral immune system by promoting TH1 responses and suppressing TH2 cytokines. Leptin influences body weight and immune responses through complex signaling pathways at molecular level. Although previous studies provide explanations for the protective role of breastfeeding against both obesity and asthma, other factors such as duration of breastfeeding, parental, and prenatal factors may confound this relationship which requires further research.
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Affiliation(s)
- Naghmeh Kian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Alireza Bagheri
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Genetics, Faculty of Basic Sciences, Shahrekord University, Shahrekord, Iran
| | - Fardis Salmanpour
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Student Research Committee, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Afsaneh Soltani
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Zahra Mohajer
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Noosha Samieefar
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Behzad Barekatain
- Division of Neonatology, Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
- USERN Office, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Dharod JM, McElhenny KS, DeJesus JM. Formula Feeding Is Associated with Rapid Weight Gain between 6 and 12 Months of Age: Highlighting the Importance of Developing Specific Recommendations to Prevent Overfeeding. Nutrients 2023; 15:4004. [PMID: 37764785 PMCID: PMC10536371 DOI: 10.3390/nu15184004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
We examined differences in mean daily calorie intake and rapid weight gain risk among 6- to 12-month-old infants by milk feeding status: breastmilk only, breastmilk and formula (combined), or formula only. Another objective was to determine what frequency and amount of formula fed were associated with overfeeding among infants. Mother-infant dyads (n = 240) were recruited from a pediatric clinic mainly serving Medicaid recipients. At 6, 9, and 12 months of infants' age, 24 h feeding recalls were conducted using the multiple-pass method. Infant weight measurements were accessed from clinic records to estimate rapid weight gain between 6 and 12 months. Among the participants, 82% received WIC. More than half of the participants were either African American or Latino by race/ethnicity. Calorie intake among formula-only fed infants was higher than in the other two milk feeding groups. One-fourth of the infants were experiencing rapid weight gain, and the risk was 3-fold higher among formula-only fed infants. Exceeding daily calorie requirements or overfeeding was associated with both formula amount and the frequency of feeding (p < 0.01). Specific guidelines and education on formula feeding practices are critical to prevent accelerated growth among infants. Gaining further understanding on parenting style and formula feeding practices is also warranted.
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Affiliation(s)
- Jigna M. Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Kristen S. McElhenny
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Jasmine M. DeJesus
- Department of Psychology, College of Arts and Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
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20
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Laws RA, Cheng H, Rossiter C, Kuswara K, Markides BR, Size D, Corcoran P, Ong K, Denney‐Wilson E. Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app. MATERNAL & CHILD NUTRITION 2023; 19:e13482. [PMID: 36725007 PMCID: PMC10019053 DOI: 10.1111/mcn.13482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023]
Abstract
Despite the well-known benefits of breastfeeding, breastfeeding rates remain suboptimal, particularly for women with lower socioeconomic position. Although popular, breastfeeding apps are often poor quality; their impact on breastfeeding knowledge, attitudes, confidence and intentions is unknown. A mixed method pre-post feasibility study was conducted to: 1) explore the feasibility of the My Baby Now app in providing perinatal breastfeeding support; 2) examine the impact on breastfeeding knowledge, attitudes, confidence and intentions; 3) to examine any differences in acceptability and impact of the app according to maternal education. The My Baby Now app was offered to pregnant women 20-30 weeks gestation. Breastfeeding knowledge and intentions were collected at baseline (T1) and 36-38 weeks gestation (T2); attitudes and confidence were collected at baseline, T2 and T3 (8-12 weeks post-partum). App engagement was measured via app analytics. Qualitative interviews were conducted with a purposeful sample following T3. Of 266 participants recruited, 169 (64%) completed T2 and 157 (59%) completed T3. Mothers without university education rated the app to be higher quality, more useful and impactful than mothers with university education. From T1-T2, breastfeeding knowledge (59.6% vs. 66.5%, p < 0.001) and exclusive breastfeeding intentions (76.6% vs. 80.9%, p < 0.001) increased. Breastfeeding attitudes and confidence scores also increased significantly across T1-T2 and T1-T3. App engagement during pregnancy predicted changes in breastfeeding attitudes from T1-T2 among participants without university education. App engagement did not predict changes in breastfeeding knowledge, confidence or intentions. Future randomised controlled studies should examine the effectiveness of mHealth interventions on breastfeeding outcomes.
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Affiliation(s)
- Rachel A. Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Heilok Cheng
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Chris Rossiter
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Brittany R. Markides
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Donna Size
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
| | - Patricia Corcoran
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
- Canterbury Hospital Maternity Unit, Sydney Local Health DistrictSydneyAustralia
| | - Kok‐Leong Ong
- Department of Information Systems and Business Analytics, AISSCRMIT UniversityMelbourneAustralia
| | - Elizabeth Denney‐Wilson
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
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21
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Oyama S, Arslanian KJ, Fidow UT, Naseri T, Soti-Ulberg C, Hawley NL. Cross-sectional and prospective associations between household socioeconomic resources, appetite traits, and body size among Samoan infants. Appetite 2023; 185:106519. [PMID: 36870391 DOI: 10.1016/j.appet.2023.106519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/08/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
In high-income countries, household socioeconomic resources (as measured by education, occupation, income, and/or household assets) and childhood obesity risk tend to be negatively associated. This association may arise in part because children from households with fewer resources are exposed to obesogenic environments that shape appetite trait development. In contrast, many low- and middle-income countries (LMICs) exhibit a positive association between socioeconomic resources and child body size. There is less evidence from LMIC settings about when during development this association emerges and whether appetite traits play a mediatory role. To explore these questions, we examined cross-sectional and longitudinal associations between socioeconomic resources, appetite traits, and body size among infants in Samoa, an LMIC in Oceania. Data were from the Foafoaga O le Ola prospective birth cohort of 160 mother-infant dyads. Appetite traits were characterized using the Baby and Child Eating Behavior Questionnaires and household socioeconomic resources were quantified using an asset-based measure. While infant body size and household socioeconomic resources were positively associated in both cross-sectional and prospective analyses, we found no evidence that appetite traits mediate this relationship. These results suggest that other aspects of the food environment, such as food security and feeding style, may explain the positive association between socioeconomic resources and body size observed in many LMICs.
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Affiliation(s)
- Sakurako Oyama
- Department of Anthropology, Yale University, 10 Sachem St, New Haven, CT, 06511, USA; Yale School of Medicine, Yale University, 333 Cedar St, New Haven, CT, 06510, USA
| | - Kendall J Arslanian
- Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College St, New Haven, CT, 06520, USA
| | - Ulai T Fidow
- Obstetrics & Gynecology, Tupua Tamasese Meaole Hospital, Samoa National Health Services, Apia, Samoa
| | | | | | - Nicola L Hawley
- Department of Anthropology, Yale University, 10 Sachem St, New Haven, CT, 06511, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College St, New Haven, CT, 06520, USA.
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22
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Dharod JM, Hernandez M, Labban JD, Black MM, Ammerman A, Frazier C, Raynor N, Ramos-Castillo I. Associations between early introduction to complementary foods, subsequent cereal-added bottle feeding and daily macronutrient intake among infants. Appetite 2023; 182:106453. [PMID: 36621723 PMCID: PMC9907061 DOI: 10.1016/j.appet.2023.106453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
Introducing complementary foods early during infancy has been associated with an increased risk of overweight later in life, but the pathway is an understudied topic. Hence the study was conducted with low-income and primarily minority mother-infant dyads to: 1) understand how the introduction of complementary foods prior to 4 months was associated with socio-demographic characteristics and food security status; 2) determine the association between early introduction to complementary foods and breastfeeding and adding cereal into the bottle in later infancy (i.e., at 6 and 9 months), and; 3) examine how adding infant cereal into the bottle was related to daily calorie and macronutrient intake in infancy. We conducted interviews with mothers (n = 201) at 4 months of age and 24-h feeding recalls at age 6 and 9 months. Results indicated that 29% of the infants were fed complementary foods before 4 months of age. Introducing complementary foods early was negatively associated with breastfeeding and positively associated with adding cereal into the bottle at 6-months. This practice was more common among those who experienced marginal to very low levels of food security. Comparing by race/ethnicity, Latinx mothers were significantly less likely to introduce solids early. After controlling for sex, infants fed cereal in the bottle were consuming significantly more calories compared to their counterparts. Specifically, adding cereal into the bottle resulted in approximately 10% additional daily calorie intake among infants. Understanding how these feeding practices affect appetite development and weight status during infancy is warranted.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA.
| | - Marlen Hernandez
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Jeffrey D Labban
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, USA; Department of Pediatrics, University of Maryland School of Medicine, USA
| | - Alice Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA; Center for Health, Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USA
| | - Christina Frazier
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Nichole Raynor
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Isa Ramos-Castillo
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
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23
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Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 210] [Impact Index Per Article: 210.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
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24
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Doan TTD, Tran TC, Pham NM, Zhao Y, Dinh TPH, Hoai NX, Lee A, Binns C, Bui TTH. Designing and developing a mobile app (BeBo) in a randomized controlled trial study to promote breastfeeding among Vietnamese mothers. Int Breastfeed J 2023; 18:7. [PMID: 36658643 PMCID: PMC9854088 DOI: 10.1186/s13006-023-00543-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/07/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Breastfeeding should begin as soon as possible after birth and continue exclusively to 6 months of age. In Vietnam, as in many other countries, breastfeeding is decreasing because of modern lifestyles and the promotion of infant formula. It is important to provide mothers, family members, and the community with the knowledge and strategies to improve breastfeeding rates. Smartphones are almost ubiquitous in Vietnam and of the potential to provide information about breastfeeding. This study aimed to document the process of designing and developing a mobile app to increase breastfeeding rates in Vietnamese women. METHODS We used a four-step mixed methods approach with a literature review, formative research (22 in-depth interviews and 49 self-administered online questionnaires), and testing of prototype apps (3 focus groups discussion and external experts). Formative research and focus group discussion involved 99 participants. Finally, the revisions of the app were tested. All of the formative research was undertaken in Hanoi in 2019-2020. Target behaviors followed by key determinants, to improve breastfeeding self-efficacy were studied and this information was then applied in developing the messages and library content. Barriers and facilitators to breastfeeding were identified from literature reviews and qualitative research. The messages were targeted at not only mothers but also included fathers, mothers-in-law, or families. RESULTS Mothers were mostly concerned about the initiation of breastfeeding, preventing and reducing difficulties encountered during breastfeeding, and nutrition for breastfeeding mothers. Mental health and well-being in the postnatal period are also concerns. Three key features to be included in the app were identified from the formative research: (1) notifications; (2) an information library; and (3) a searching function. The research found that the app should be installed during pregnancy rather than after delivery (81% vs 17%, respectively). Notifications that convey breastfeeding messages should be sent 2-3 times per week. CONCLUSION The development of the app followed a best practice approach, including the involvement of stakeholders and grounding in behavior change theory. The next step is to evaluate the effectiveness of the BeBo mobile app in a well-conducted randomized controlled trial. TRIAL REGISTRATION ACTRN12619000531112.
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Affiliation(s)
- Thi Thuy Duong Doan
- Faculty of Social Sciences, Behaviour and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi, 10000 Vietnam
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Trung Chuyen Tran
- Faculty of Information Technology, Department of Hanoi University of Mining and Geology, 18 Vien Street - Bac Tu Liem District, Hanoi, 10000 Vietnam
| | - Ngoc Minh Pham
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City, 250000 Vietnam
| | - Yun Zhao
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Thi Phuong Hoa Dinh
- Faculty of Social Sciences, Behaviour and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi, 10000 Vietnam
| | - Nguyen Xuan Hoai
- Faculty of Information Technology, HUTECH University, Ho Chi Minh City, 700000 Vietnam
| | - Andy Lee
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Colin Binns
- School of Public Health, Curtin University, Bentley, Western Australia 6102 Australia
| | - Thi Thu Ha Bui
- Faculty of Social Sciences, Behaviour and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi, 10000 Vietnam
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25
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Yuan M, Lu M, Guo Y, Lam KBH, Lu J, He J, Shen S, Wei D, Thomas GN, Cheng KK, Qiu X. Timing of infant formula introduction in relation to BMI and overweight at ages 1 and 3 years: the Born in Guangzhou Cohort Study (BIGCS). Br J Nutr 2023; 129:166-174. [PMID: 35264258 DOI: 10.1017/s000711452200071x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Mounting evidence suggests that the first few months of life are critical for the development of obesity. The relationships between the timing of solid food introduction and the risk of childhood obesity have been examined previously; however, evidence for the association of timing of infant formula introduction remains scarce. This study aimed to examine whether the timing of infant formula introduction is associated with growth z-scores and overweight at ages 1 and 3 years. This study included 5733 full-term (≥ 37 gestational weeks) and normal birth weight (≥ 2500 and < 4000 g) children in the Born in Guangzhou Cohort Study, a prospective cohort study with data collected at 6 weeks, 6, 12 and 36 months. Compared with infant formula introduction at 0-3 months, introduction at 4-6 months was associated with the lower BMI, weight-for-age and weight-for-length z-scores at 1 and 3 years old. Also, introduction at 4-6 months was associated with the lower odds of at-risk of overweight at age 1 (adjusted OR 0·72, 95 % CI 0·55, 0·94) and 3 years (adjusted OR 0·50, 95 % CI 0·30, 0·85). Introduction at 4-6 months also decreased the odds of overweight at age 1 year (adjusted OR 0·42, 95 % CI 0·21, 0·84) but not at age 3 years. Based on our findings, compared with introduction within the first 3 months, introduction at 4-6 months has a reduction on later high BMI risk and at-risk of overweight. However, these results need to be replicated in other well-designed studies before more firm recommendations can be made.
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Affiliation(s)
- Mingyang Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Minshan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Yixin Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | | | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Jianrong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Dongmei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
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26
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Dalili S, Koohmanaee S, Badeli H, Rad A, Novin M, Mostofizadeh N, Kazemnejad-Leili E. Predicting childhood overweight status by accelerated weight gain from neonatal period to infancy. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2023; 28:2. [PMID: 36974114 PMCID: PMC10039107 DOI: 10.4103/jrms.jrms_1041_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/21/2022] [Accepted: 10/12/2022] [Indexed: 02/04/2023]
Abstract
Background The increased prevalence of obesity in early childhood is a public health problem. Childhood obesity may affect cardiorespiratory fitness and can induce obesity and its comorbidities in adulthood. We aimed to assess childhood overweight status by accelerated weight gain during infancy. Materials and Methods This is a historical cohort that was conducted on 637 7-year-old students of Guilan province, north of Iran. Data were collected, including demographic characteristics, weight at 4, 6, 12, and 18 months, and clinical examination. The ROC curve was designated based on the standardized z-scores, and the most appropriate cutoff point by sensitivity and specificity was noted for predicting obesity at 7 years. Rapid weight gain (RWG) was also assessed. Results Among participants, 334 (53.3%) were female. In this study, the mean and standard deviation of RWG in 0-4 months, 0-6 months, 0-12 months, and 0-18 months were 3.50 ± 0.89, 4.64 ± 1.02, 6.54 ± 1.21, and 8.00 ± 1.46 kg, respectively. The highest AUC was dedicated to 0-18 months (0.7 ± 0.05) and the suitable cut-off for RWG in this interval was 8.55 kg with 65.5% and 72.0% sensitivity and specificity, respectively. Conclusion Although in the previous investigations, the changes in the first 3 years of life had a significant role in further complications, regarding our results, it seems that even earlier consideration of excess weight gain may be necessary.
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27
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Nelson TB, Caiola CE, Tyndall DE. Integrative Review of Mental Health and Feeding Styles in Parents of Bottle-Fed Infants. J Obstet Gynecol Neonatal Nurs 2023; 52:21-35. [PMID: 36442519 PMCID: PMC9839476 DOI: 10.1016/j.jogn.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review the literature regarding the relationship between symptoms of anxiety and depression and feeding styles in parents of bottle-fed infants. DATA SOURCES We conducted literature searches in PubMed, CINAHL, Scopus, and PsycINFO. STUDY SELECTION We used Covidence systematic review management software during the selection process to allow for full blinding of decisions by team members. Articles were eligible for inclusion if they were reports of primary research, written in English, and focused on the relationship between symptoms of anxiety or depression and feeding styles in parents of term, bottle-fed infants younger than 12 months of age. We placed no restriction on date of publication because of the sparse amount of published literature on this topic. We identified a total of 1,882 articles. After removing duplicates, we screened 988 articles and retained six articles that met criteria for our review. DATA EXTRACTION We used Whittemore and Knafl's integrative review methodology to guide data extraction and reporting. We extracted relevant data from all primary data sources and compiled the data into a matrix. We used the Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies to assess the quality of the studies. DATA SYNTHESIS Using an a priori coding scheme, we summarized the data using categorization of established parental feeding styles in infancy applicable to bottle-feeding. We synthesized the data into two broad categories: responsive and nonresponsive feeding styles. CONCLUSION Although research on the topic is limited, our findings suggest that symptoms of postpartum depression may be associated with nonresponsive feeding styles in parents of bottle-fed infants. We suggest several areas for future research and recommend increased emotional and feeding support in practice for parents of bottle-feeding infants.
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28
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Zahra L, Kremer P, Bolton KA. A cross-sectional study of infant feeding practices in Vietnamese-born mothers living in Australia. BMC Pregnancy Childbirth 2022; 22:895. [PMID: 36463117 PMCID: PMC9719657 DOI: 10.1186/s12884-022-05223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/16/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Infant feeding practices are a key modifiable risk factor for childhood overweight and obesity; and important for lifelong health and wellbeing. Despite the growing Australian immigrant population, it is unclear how infant feeding practices may differ between ethnicities living in Australia. Few studies have examined the infant feeding practices of Vietnamese mothers who migrate and give birth to infants in Australia - termed Vietnamese-born mothers. The aim of this study was to examine differences in infant feeding practices (breastfeeding, formula feeding and complementary feeding (other fluids and solids)) in Vietnamese-born mothers compared with Australian-born mothers living in Australia. METHOD This study analysed the Australian National Infant Feeding Survey dataset (2010-11), a large national cross-sectional survey measuring feeding practices of infants aged 0-24 months old. Infant feeding practices of Vietnamese-born mothers (n = 261) and a random sub-sample of Australian-born mothers (n = 261) were compared. Associations between ethnicity and infant feeding practices were examined through logistic and linear regression adjusting for maternal age, socioeconomic status, body mass index (BMI) at start of pregnancy, infant age at survey completion and parity. Compliance with the Australian national infant feeding guidelines was also assessed. RESULTS Compliance with infant feeding guidelines was low, with differences in infant feeding practices between groups. At the time of survey completion, when infants were on average 7.2 months old, compared with infants of Australian-born mothers, infants to Vietnamese-born mothers were significantly younger when first exposed to fruit juice (b = -2.41, 95%CI: -4.54- -0.28); less likely to be exposed to solids (AOR: 0.15, 95%CI: 0.05-0.44) and more likely to be exposed to formula milks (AOR: 2.21, 95%CI: 1.10-4.43); toddler milks (AOR: 16.72, 95%CI: 3.11-90.09) and fruit juice (AOR: 2.37, 95%CI: 1.06-5.32) (p < 0.05). CONCLUSION Low adherence with breastfeeding (low breastfeeding and high infant formula use) and other fluids (toddler milks and fruit juice) recommendations outlined by the Australian infant feeding guidelines were observed in this group of Vietnamese-born mothers. To optimise feeding and growth in Vietnamese-Australian children, culturally appropriate infant feeding support targeting breastfeeding durations, reducing reliance on infant formula, and reducing inappropriate introduction to other fluids should be the focus of infant feeding promotion within these mothers.
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Affiliation(s)
- Lauren Zahra
- grid.1021.20000 0001 0526 7079School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC Australia
| | - Peter Kremer
- grid.1021.20000 0001 0526 7079Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC Australia
| | - Kristy A. Bolton
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC Australia
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29
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Fangupo L, Daniels L, Taylor R, Glover M, Taungapeau F, Sa'u S, Cutfield W, Taylor B. The care of infants with rapid weight gain: Should we be doing more? J Paediatr Child Health 2022; 58:2143-2149. [PMID: 36259748 PMCID: PMC10092129 DOI: 10.1111/jpc.16247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/28/2022]
Abstract
Rapid weight gain (RWG) during infancy is a known risk factor for later childhood obesity. It can be measured using a range of definitions across various time periods in the first 2 years of life. In recent years, some early childhood obesity prevention trials have included a focus on preventing RWG during infancy, with modest success. Overall, RWG during infancy remains common, yet little work has examined whether infants with this growth pattern should receive additional care when it is identified in health-care settings. In this viewpoint, we contend that RWG during infancy should be routinely screened for in health-care settings, and when identified, viewed as an opportunity for health-care professionals to instigate non-stigmatising discussions with families about RWG and general healthy practices for their infants. If families wish to engage, we suggest that six topics from early life obesity prevention studies (breastfeeding, formula feeding, complementary feeding, sleep, responsive parenting, and education around growth charts and monitoring) could form the foundations of conversations to help them establish and maintain healthy habits to support their infant's health and well-being and potentially lower the risk of later obesity. However, further work is needed to develop definitive guidelines in this area, and to address other gaps in the literature, such as the current lack of a standardised definition for RWG during infancy and a clear understanding of the time points over which it should be measured.
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Affiliation(s)
- Louise Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin, New Zealand.,Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.,A Better Start National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Marewa Glover
- Papaharakeke International Ltd, Auckland, New Zealand
| | | | | | - Wayne Cutfield
- A Better Start National Science Challenge, University of Auckland, Auckland, New Zealand.,The Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Barry Taylor
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.,A Better Start National Science Challenge, University of Auckland, Auckland, New Zealand
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30
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Hernandez E, Lavner JA, Moore AM, Stansfield BK, Beach SRH, Smith JJ, Savage JS. Sleep SAAF responsive parenting intervention improves mothers' feeding practices: a randomized controlled trial among African American mother-infant dyads. Int J Behav Nutr Phys Act 2022; 19:129. [PMID: 36183135 PMCID: PMC9526457 DOI: 10.1186/s12966-022-01366-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background/Objective Parents shape children’s early experiences with food, influencing what is served, children’s food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers’ infant feeding practices. Methods Primiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not). Results RP mothers reported more responsive feeding (p = 0.005, partial η2 = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2–0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η2 = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η2 = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe. Conclusions Responsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls. Trial registration Sleep SAAF: A Strong African American Families Study. www.clinicaltrials.gov NCT03505203. Registered 3 April 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01366-1.
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Affiliation(s)
- Erika Hernandez
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA, USA
| | - Justin A Lavner
- Department of Psychology, Psychology Building, University of Georgia, Athens, GA, 30602-3013, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA, USA
| | | | - Steven R H Beach
- Department of Psychology, Psychology Building, University of Georgia, Athens, GA, 30602-3013, USA.,Center for Family Research, University of Georgia, Athens, GA, USA
| | - Jessica J Smith
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA, USA
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Moore AM, Smith JJ, Stansfield BK, Savage JS, Lavner JA. Patterns and Predictors of Breast Milk Feeding from Birth to Age 4 Months among Primiparous African American Mother–Infant Dyads. Nutrients 2022; 14:nu14112350. [PMID: 35684150 PMCID: PMC9182812 DOI: 10.3390/nu14112350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
The health benefits of breast milk feeding have been well-established, yet disparities exist, with African American mothers having the lowest breast milk feeding rates in the United States. This prospective, longitudinal study examined infant feeding (breast milk and/or infant formula) from birth to age 16 weeks, predictors of any breast milk feeding by age 1 week, and predictors of cessation of any breast milk feeding by ages 3, 8, and 16 weeks among primiparous African American mothers. This secondary analysis included 185 mother–infant dyads from the Sleep SAAF (Strong African American Families) study, a randomized clinical trial testing a responsive parenting vs. child safety control intervention. Mothers reported sociodemographic and psychosocial characteristics at age 1 week and infant feeding practices at ages 1, 3, 8, and 16 weeks. Rates of any breast milk feeding decreased from 66.5% at 1 week to 23.3% at 16 weeks. Bivariate logistic regression models showed that prepregnancy BMI (OR = 1.09), working prepregnancy (OR = 2.25), and food insecurity (OR = 2.49) significantly increased the odds of mothers feeding any breast milk by 1 week, whereas Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation (OR = 0.21) significantly decreased the odds. Bivariate logistic regression models showed that Supplemental Nutrition Assistance Program (SNAP) participation (OR = 2.86) and racial discrimination (OR = 2.14) significantly increased the odds of cessation of any breast milk feeding by 3 weeks. SNAP (OR = 2.33) and WIC (OR = 2.38) participation significantly increased the odds of cessation of any breast milk feeding by 8 weeks, whereas higher prepregnancy BMI (OR = 0.95) decreased the odds. Higher mother’s age (OR = 0.92) significantly decreased the odds of cessation of any breast milk feeding by 16 weeks. The findings can be used to inform targeted interventions to promote mothers feeding any breast milk and help reduce breast milk feeding disparities among African American mothers.
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Affiliation(s)
- Amy M. Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802, USA;
- Correspondence:
| | - Jessica J. Smith
- Center for Family Research, University of Georgia, Athens, GA 30602, USA;
| | - Brian K. Stansfield
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802, USA;
| | - Justin A. Lavner
- Department of Psychology, University of Georgia, 156 Psychology Building, Athens, GA 30602, USA;
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32
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Buckingham A, Kenneson A, Singh RH. Breastfeeding practices for infants with inherited metabolic disorders: A survey of registered dietitians in the United States and Canada. Mol Genet Metab Rep 2022; 31:100865. [PMID: 35782610 PMCID: PMC9248230 DOI: 10.1016/j.ymgmr.2022.100865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 12/30/2022] Open
Abstract
Background Objective Design Results Conclusions
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33
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Cheng H, Rossiter C, Size D, Denney‐Wilson E. Comprehensiveness of infant formula and bottle feeding resources: A review of information from Australian healthcare organisations. MATERNAL & CHILD NUTRITION 2022; 18:e13309. [PMID: 34913262 PMCID: PMC8932696 DOI: 10.1111/mcn.13309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 12/14/2022]
Abstract
The use of infant formula is widespread internationally. In Australia, 55% of infants receive formula before 6 months of age, with higher rates among disadvantaged communities. Infant formula use can contribute to childhood overweight and obesity, through formula composition and feeding behaviours, such as adding cereal to bottles and parental feeding style. While information abounds to promote and support breastfeeding, formula‐feeding parents report a paucity of advice and support; many rely on formula packaging for information. This study systematically searched and reviewed online resources for infant formula and bottle feeding from Australian governments, health services, hospitals, and not‐for‐profit parenting organisations. A comprehensive search strategy located 74 current resources, mostly for parents. Researchers evaluated the resources against best practice criteria derived from Australian government and UNICEF guidelines on six topics. They assessed how comprehensively the resources addressed each topic and whether the resources provided all the information necessary for parents to understand each topic. The mean ‘comprehensiveness’ rating for topics across all resources was 54.36%. However, some topics were addressed more fully than others. Information on ‘discussing infant formula with health workers’ and on ‘preparing infant formula’ was more frequently accurate and comprehensive. However, there was much less comprehensive information on ‘using infant formula’, including amounts of formula to feed, use of bottle teats, appropriate bottle‐feeding practice and responsiveness to infant satiety cues. Over half the resources were written at an acceptable reading level. Insufficient formula‐feeding support from health services can lead to parents relying on formula packaging or other commercial information. Most formula‐feeding resources from Australian healthcare organisations focus on preparing infant formula and using infant formula. However, comprehensiveness of information varies—on average, information on preparing infant formula was more comprehensive than that on using infant formula. Many resources do not address responsive bottle‐feeding practices, which impacts risk of infant overweight and obesity. The Australian government infant feeding guidelines should be revised to include more comprehensive best‐practice formula‐feeding recommendations; subsequently, this should be reflected in formula‐feeding information from health organisations.
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Affiliation(s)
- Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Donna Size
- Child and Family Health Nursing Sydney Local Health District, NSW Health Camperdown New South Wales Australia
- Women and Babies Royal Prince Alfred Hospital, Sydney Local Health District, NSW Health Camperdown New South Wales Australia
| | - Elizabeth Denney‐Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Sydney Institute for Women, Children and their Families Sydney Local Health District, NSW Health Camperdown New South Wales Australia
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34
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Bai G, Parkash A, Kumar V, Kumari M, Kumari S, Das K. Trends in Weight Gain Among Breastfed Infants Versus Bottle-Fed Infants at a Tertiary Care Hospital in Karachi, Pakistan. Cureus 2022; 14:e23459. [PMID: 35494905 PMCID: PMC9038507 DOI: 10.7759/cureus.23459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/05/2022] Open
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35
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Muñoz-Esparza NC, Vásquez-Garibay EM, Guzmán-Mercado E, Larrosa-Haro A, Comas-Basté O, Latorre-Moratalla ML, Veciana-Nogués MT, Vidal-Carou MC. Influence of the Type of Breastfeeding and Human Milk Polyamines on Infant Anthropometric Parameters. Front Nutr 2022; 8:815477. [PMID: 35071304 PMCID: PMC8770740 DOI: 10.3389/fnut.2021.815477] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/09/2021] [Indexed: 11/22/2022] Open
Abstract
Feeding choices in the early months of life are key determinants of growth during infancy. Polyamines participate in cell proliferation and differentiation, and it has also been suggested that polyamine metabolism plays a role in adipogenesis. As the main exogenous source of polyamines in the infant is human milk, the aim of this work was to study if the type of breastfeeding received and the polyamine intake from human milk has an influence on infant anthropometric parameters. A cohort of 78 full-term healthy newborns was followed up until 4 months of age; 55 were fully and 23 partially breastfed. Anthropometric measurements were taken at 2 and 4 months, when human milk samples were also collected for analysis of polyamine content by UHPLC-FL. Fully breastfed infants had a better anthropometric profile than those partially breastfed (p < 0.05). Furthermore, polyamine intake in partially breastfed infants was significantly lower compared to those fully breastfed. However, only two of the 15 anthropometric indicators evaluated (triceps skinfold and mean upper arm circumference) showed a significant inverse association with polyamine content in human milk and intake (p < 0.05). Infant growth and body composition differ according to the type of breastfeeding received. Based on the weak associations between polyamines and anthropometric indicators, it is not possible to conclude the influence of polyamines in infant growth and body composition.
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Affiliation(s)
- Nelly C Muñoz-Esparza
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Xarxa d'Innovació Alimentària (XIA), Barcelona, Spain.,Instituto de Nutrición Humana, Universidad de Guadalajara, Guadalajara, Mexico
| | | | | | | | - Oriol Comas-Basté
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Xarxa d'Innovació Alimentària (XIA), Barcelona, Spain
| | - M Luz Latorre-Moratalla
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Xarxa d'Innovació Alimentària (XIA), Barcelona, Spain
| | - M Teresa Veciana-Nogués
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Xarxa d'Innovació Alimentària (XIA), Barcelona, Spain
| | - M Carmen Vidal-Carou
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Santa Coloma de Gramenet, Spain.,Xarxa d'Innovació Alimentària (XIA), Barcelona, Spain
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36
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Interventions Targeting Bottle and Formula Feeding in the Prevention and Treatment of Early Childhood Caries, Overweight and Obesity: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312304. [PMID: 34886023 PMCID: PMC8656950 DOI: 10.3390/ijerph182312304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/21/2022]
Abstract
Overweight, obesity and early childhood caries (ECC) are preventable conditions affecting infants and young children, with increased prevalence in those formula-fed. Previous research has focused on distinct outcomes for oral health and healthy weight gain. However, the aetiology may be linked through overlapping obesogenic and cariogenic feeding behaviours, such as increased sugar exposure through bottle propping and overfeeding. Best-practice bottle feeding and transition to cup use may concurrently reduce overweight, obesity and ECC. This integrative review aimed to identify interventions supporting best-practice formula feeding or bottle cessation and examine the intervention effects on feeding, oral health and weight outcomes. The reviewers searched nine databases and found 27 studies that met the predetermined inclusion criteria. Eighteen studies focused on populations vulnerable to ECC or unhealthy weight gain. All studies focused on carer education; however, only 10 studies utilised behaviour change techniques or theories addressing antecedents to obesogenic or cariogenic behaviours. The outcomes varied: 16 studies reported mixed outcomes, and eight reported worsened post-intervention outcomes. While some studies reported improvements, these were not maintained long-term. Many study designs were at risk of bias. Effective intervention strategies for preventing ECC and child obesity require the holistic use of interdisciplinary approaches, consumer co-design and the use of behavioural change theory.
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Associations between mothers' use of food to soothe, feeding mode, and infant weight during early infancy. Appetite 2021; 168:105736. [PMID: 34627981 PMCID: PMC8671361 DOI: 10.1016/j.appet.2021.105736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/18/2022]
Abstract
Weight status and rate of weight gain in the first six months postpartum are strong predictors of later obesity; thus, infant feeding practices are an important target for obesity prevention efforts. The use of food to soothe (FTS) is associated with less-favorable eating habits and weight outcomes for older infants and children. However, few studies have examined correlates of use of FTS during early infancy. The primary aim of this cross-sectional study was to explore associations between use of FTS and infant weight status in the first 6 months postpartum. A secondary aim was to identify the combination of maternal and infant characteristics that predicted use of FTS. Mothers of infants aged 6 months or younger (N = 134) completed questionnaires assessing use of FTS, bottle-feeding intensity (i.e., percentage of daily feedings from bottles versus directly from the breast), levels of responsive and pressuring feeding styles, dimensions of infant temperament and eating behaviors, and family demographics. Dyads were observed during feeding to assess maternal sensitivity to infant cues and responsiveness to infant distress and infant clarity of cues and responsiveness to the mother. Infant weight and length at study entry were assessed by a trained research assistant. Use of FTS was not associated with infant weight for age z-score (WAZ), even when bottle-feeding intensity was considered as a moderator. More frequent use of FTS was predicted by the combination of greater levels of pressuring feeding style (p = .005) and infant temperamental negative affectivity (p = .001), and lower levels of infant temperamental surgency/extraversion (p = .018). In conclusion, use of FTS was associated with dimensions of infant temperament and maternal feeding style, but not with WAZ during early infancy.
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38
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Stokes A, Campbell KJ, Yu HJ, Szymlek-Gay EA, Abbott G, He QQ, Zheng M. Protein Intake from Birth to 2 Years and Obesity Outcomes in Later Childhood and Adolescence: A Systematic Review of Prospective Cohort Studies. Adv Nutr 2021; 12:1863-1876. [PMID: 33903896 PMCID: PMC8483959 DOI: 10.1093/advances/nmab034] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/18/2022] Open
Abstract
Emerging evidence shows an association between protein intake during infancy and later obesity risk, and that association may differ by protein sources. This systematic review summarized and evaluated prospective cohort studies assessing the long-term association of total protein intake and protein sources during infancy (from birth to 2 y) with subsequent obesity outcomes in childhood or adolescence. Literature searches were conducted in Embase, Medline, Scopus, and Web of Science. Sixteen studies that reported associations between total protein intake and/or protein intake from different sources from birth to 2 y and ≥1 obesity outcomes in childhood or adolescence from 9 cohorts were identified. Most studies (11/16) were rated as high quality. The most frequently reported association was total protein intake and BMI (up to 10 y) with 6 out of 7 cohorts showing significant positive associations. Similar associations were found for animal protein, but not for plant protein. Limited studies examined the association between protein intake (both total and sources) and body composition (body fat, fat mass, and fat-free mass) and revealed inconsistent findings. Overall, higher intakes of total and animal protein during infancy were associated with higher BMI in childhood and adolescence. Future studies investigating the contribution of protein sources in long-term obesity development are needed. This review was registered at PROSPERO as CRD42020166540.
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Affiliation(s)
- Alexandra Stokes
- School of Exercise and Nutrition eSciences, Deakin University, Geelong, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Hong-Jie Yu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Qi-Qiang He
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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39
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Barrett KJ, Thompson AL. Infant eating behaviors and Milk feeding independently predict infant size. Am J Hum Biol 2021; 34:e23678. [PMID: 34506053 DOI: 10.1002/ajhb.23678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES This study investigates the association of infant eating behaviors with infant size, and if those associations are mediated by infant feeding. METHODS Mothers with infants less than 12 months of age and living in Central North Carolina were enrolled (N = 61). Data were collected at baseline and at 3- and 6-month follow up visits. Modified constructs from the Baby Eating Behavior Questionnaire (BEBQ) and Child Eating Behavior Questionnaire (CEBQ) measured parents' perceptions of infant eating behaviors related to food approach (enjoyment of food, and food responsiveness) and food avoidance (food fussiness, satiety responsiveness, and slowness in eating). Linear mixed effects models tested longitudinal associations among infant eating behavior ratings, infant feeding (breastfeeding intensity, timing of introduction of complementary foods), and anthropometry (weight, length, and weight-for-length z-scores). Path analyses were stratified by age and tested for direct and indirect effects of mothers' ratings of infant eating behaviors and infant feeding on infant anthropometry. RESULTS Linear mixed models showed that general appetite was associated with higher weight-for-age, and satiety responsiveness was associated with lower length-for-age. Path analyses showed that infant milk feeding did not mediate associations. Breastfeeding intensity was independently associated with lower weight- and length-for-age z-scores. Age at complementary feeding initiation was associated with lower length-for-age z-scores. CONCLUSIONS Associations between parental perceptions of general appetite, satiety responsiveness, and infant weight and length are observed early in life. These findings suggest that parental perceptions of infant eating behaviors may contribute to the early developmental programming of later health outcomes.
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Affiliation(s)
- Katherine J Barrett
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amanda L Thompson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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40
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Norris T, Mansukoski L, Gilthorpe MS, Hamer M, Hardy R, Howe LD, Li L, Ong KK, Ploubidis GB, Viner RM, Johnson W. Early childhood weight gain: Latent patterns and body composition outcomes. Paediatr Perinat Epidemiol 2021; 35:557-568. [PMID: 33960515 DOI: 10.1111/ppe.12754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/26/2020] [Accepted: 01/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist. OBJECTIVES To identify and characterise distinct groups of children displaying similar early-life weight trajectories. METHODS A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated. RESULTS The best model had five classes. The "Normal" (45%) and "Normal after initial catch-down" (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The "High-decreasing" (21%) and "Stable-high" (7%) classes peaked at the ~91st centile at 12-18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The "Rapidly increasing" (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio-economic position. At 9 years, the "Rapidly increasing" class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the "Normal" class, but only 14.0% (95% CI 9.1, 18.9) more lean mass. CONCLUSIONS Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.
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Affiliation(s)
- Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Liina Mansukoski
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mark S Gilthorpe
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Alan Turing Institute, British Library, London, UK
| | - Mark Hamer
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, University College London, London, UK
| | - Rebecca Hardy
- CLOSER, Department of Social Science, University College London, London, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK
| | - Leah Li
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ken K Ong
- MRC Epidemiology Unit and Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College London, London, UK
| | - Russell M Viner
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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41
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Fujita Y, Kouda K, Ohara K, Nakamura H, Nakama C, Nishiyama T, Iki M. Infant weight gain and DXA-measured adolescent adiposity: data from the Japan Kids Body-composition Study. J Physiol Anthropol 2021; 40:10. [PMID: 34452643 PMCID: PMC8399705 DOI: 10.1186/s40101-021-00261-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/19/2021] [Indexed: 12/25/2022] Open
Abstract
Background Rapid weight gain in early life is associated with adiposity later in life. However, there is limited information on the association between weight gain and body fat mass measured using precise methods. This study aimed to investigate whether weight gain is associated with body fat mass measured by dual-energy X-ray absorptiometry (DXA) in adolescents. Methods Participants of this retrospective cohort study were 423 adolescents born at full-term who were enrolled in the Japan Kids Body-composition Study. Anthropometric measurements related to pregnancy, delivery, and child health were obtained from the Japanese Maternal and Child Health Handbook. Fat mass in adolescents was measured with a DXA scanner. Weight gain was defined as the change in body weight from birth to age 1.5 years. Associations between birthweight and fat mass, and between weight gain and fat mass, were evaluated using multiple regression analysis. Results There was a significant positive association between weight gain from birth to age 1.5 years and fat mass in adolescents (boys: standardized regression coefficient (β) = 0.253, p < 0.01; girls: β = 0.246, p < 0.01), but not between birthweight standardized for gestational age and fat mass. Conclusion Children with a greater change in weight from birth to age 1.5 years tended to have increased fat mass in adolescence. Weight gain in early life has a greater impact on fat mass in adolescents than birthweight.
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Affiliation(s)
- Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Kumiko Ohara
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Harunobu Nakamura
- Department of Human Development, Graduate School of Human Development and Environment, Kobe University, Kobe, 657-8501, Japan
| | - Chikako Nakama
- Department of Hygiene and Public Health, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Toshimasa Nishiyama
- Department of Hygiene and Public Health, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan
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42
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Jin H, Shan T, Li S, Fan X, Zhao Y, Li J, Tang X, Saffery R, Tong C, Wen L, Qi H, Kilby MD, Baker PN. Association of infant feeding patterns with body fat mass and obesity in the first 2 years of life: a longitudinal twin birth cohort study. Int J Food Sci Nutr 2021; 73:263-273. [PMID: 34412548 DOI: 10.1080/09637486.2021.1968357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Childhood obesity is a major public health problem with no effective intervention. We explored the influence of feeding patterns on infants' growth indices within the first 2 years in a twin birth cohort. Dietary intake at 12 months was recorded with a food frequency questionnaire, and dietary patterns were identified by principal component analysis. Milk feeding methods in first 6 months were categorised as breastfeeding or exclusive formula feeding. Correlations between feeding patterns and infants' growth indices were examined via generalised estimating equations. Two dietary patterns were identified and neither of which was related to growth indices. Breastfed infants had a higher body fat mass (BFM) percentage at 12 months, a higher body mass index (BMI) increment from birth to 6 months and a lower BMI increment from 6 to 12 months. Breastfed infants were likely positively correlated with BFM at 12 months; as complementary food was added, the effect of breastfeeding on growth gradually decreased.
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Affiliation(s)
- Huili Jin
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tengfei Shan
- Department of Obstetrics and Gynecology, The First People's Hospital of Yuhang District, Hangzhou, China
| | - Sisi Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Fan
- Department of Child Healthcare, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yan Zhao
- Department of Child Healthcare, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jie Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiqin Tang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Richard Saffery
- Cancer, Disease and Developmental Epigenetics, Murdoch Children's Research Institute, Parkville, Australia
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mark D Kilby
- Institute of Metabolism & Systems Research, University of Birmingham, Birmingham, UK
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, UK
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43
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Kaufman TK, Lynch BA, Wilkinson JM. Childhood Obesity: An Evidence-Based Approach to Family-Centered Advice and Support. J Prim Care Community Health 2021; 11:2150132720926279. [PMID: 32501125 PMCID: PMC7278289 DOI: 10.1177/2150132720926279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The prevalence of childhood obesity continues to rise despite decades of clinical and public health efforts. Early identification of children at risk of developing obesity is essential using newer electronic health systems, which move beyond traditional growth charts to provide a wealth of information about body mass index and other relevant parameters such as social determinants of health and comorbid conditions. For children who already have obesity, there are several evidence-based strategies health care providers can use as they work with patients and families to mitigate the effects. First and foremost, providers should address the issue; unfortunately, weight is often not discussed in clinical practice. In addressing the issue, providers should support families through effective, positive relationships. Providers must be aware of their biases; their language should be appropriate and nonstigmatizing. Helpful interventions should focus on behavior, not weight, health, or appearance. Motivational interviewing may be used to promote healthful behaviors: supportive parenting, regular exercise, healthful food choices, minimal screen time, and optimal sleep. There is limited evidence for the efficacy of specific weight loss diets. Both medication and bariatric surgery are indicated for select adolescents who have severe disease unresponsive to behavioral management.
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Affiliation(s)
- Tara K. Kaufman
- Mayo Clinic, Rochester, MN, USA
- Tara K. Kaufman, Department of Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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44
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Role of Dietary Factors, Food Habits, and Lifestyle in Childhood Obesity Development: A Position Paper From the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2021; 72:769-783. [PMID: 33720094 PMCID: PMC9770153 DOI: 10.1097/mpg.0000000000003075] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
ABSTRACT Childhood obesity has high societal and economic impact but current treatment approaches are sub-optimal. In the last decade, important studies have been conducted aiming to identify strategies to prevent obesity during critical periods of life. Updated recommendations for childhood obesity prevention are needed. We present data from systematic reviews and meta- analysis, randomised controlled trials (RCTs) and large observational studies, published from 2011 onwards that consider the possible role of the following factors in obesity development: breast-feeding; macronutrient composition and method of complementary feeding; parenting style; dietary patterns; sugar-sweetened beverage consumption; eating behaviour (eg, skipping breakfast, family dinners. etc); meal frequency and composition (fast foods, snacking), portion size; dietary modulators of gut microbiota (including pre-, pro-, and synbiotics); physical activity and sedentary behaviour. We used the Medline database and the Cochrane Library to search for relevant publications. Important research gaps were also identified. This position paper provides recommendations on dietary factors, food habits, and lifestyle to prevent childhood obesity development, based on the available literature and expert opinion. Clinical research and high-quality trials are urgently needed to resolve numerous areas of uncertainty.
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45
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Rossiter C, Cheng H, Appleton J, Campbell KJ, Denney-Wilson E. Addressing obesity in the first 1000 days in high risk infants: Systematic review. MATERNAL AND CHILD NUTRITION 2021; 17:e13178. [PMID: 33780128 PMCID: PMC8189222 DOI: 10.1111/mcn.13178] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/11/2022]
Abstract
Early intervention is critical for addressing the challenge of childhood obesity. Yet many preventive interventions do not target infants most at risk of future overweight or obesity. This systematic review examines interventions delivered before 2 years that aim to ameliorate excess weight gain among infants at high risk of overweight or obesity, due to sociodemographic characteristics, parental weight or health status, infant feeding or health behaviours. We searched six databases for interventions: (a) delivered before age two, (b) specifically aimed at infants at high risk of childhood obesity and (c) that reported outcomes by weight status beyond 28 days. The search identified over 27,000 titles, and 49 papers from 38 studies met inclusion criteria: 10 antenatal interventions, 16 postnatal and 12 conducted both before and after birth. Nearly all targeted infant and/or maternal nutrition. Studies varied widely in design, obesity risk factors, outcomes and quality. Overall, nine interventions of varying quality reported some evidence of significantly improved child weight trajectory, although effects tended to diminish over time. Interventions that improved weight outcomes tended to engage parents for a longer period, and most offered health professional input and support. Two studies of limited quality reported significantly worse weight outcomes in the intervention group.
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Affiliation(s)
- Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jessica Appleton
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Women, Children and their Families, Sydney, New South Wales, Australia.,Tresillian Family Care Centres, Belmore, New South Wales, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Women, Children and their Families, Sydney, New South Wales, Australia
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46
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Appetite self-regulation declines across childhood while general self-regulation improves: A narrative review of the origins and development of appetite self-regulation. Appetite 2021; 162:105178. [PMID: 33639246 DOI: 10.1016/j.appet.2021.105178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 02/07/2023]
Abstract
This narrative review discusses the origins and development of appetite self-regulation (ASR) in childhood (from infancy to age 6 or 7 years). The origins, or foundations, are the biological infrastructure associated with appetite regulation and appetite self-regulation. Homeostatic regulation in infancy is examined and then evidence about developmental change in components of ASR. The main ASR-related components covered are: delay-of-gratification, caloric compensation, eating in the absence of hunger, food responsiveness/hedonics and fussy eating. The research included behavioral measures, parent-reports of appetitive traits and fMRI studies. There were two main trends in the evidence: a decline across childhood in the components of ASR associated with food approach (and therefore an increase in disinhibited eating), and wide individual differences. The decline in ASR contrasts with general self-regulation (GSR) where the evidence is of an improvement across childhood. For many children, bottom-up automatic reactive processes via food reward/hedonics or food avoidance as in fussy eating, appear not to be matched by improvements in top-down regulatory capacities. The prominence of bottom-up processes in ASR could be the main factor in possible differences in developmental paths for GSR and ASR. GSR research is situated in developmental science with its focus on developmental processes, theory and methodology. In contrast, the development of ASR at present does not have a strong developmental tradition to access and there is no unifying model of ASR and its development. We concluded (1) outside of mean-level or normative changes in the components of ASR, individual differences are prominent, and (2) there is a need to formulate models of developmental change in ASR together with appropriate measurement, research designs and data analysis strategies.
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47
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Milk Fat Globule Membrane Supplementation in Children: Systematic Review with Meta-Analysis. Nutrients 2021; 13:nu13030714. [PMID: 33668227 PMCID: PMC7996302 DOI: 10.3390/nu13030714] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Milk fat globule membrane (MFGM), composing fat droplets responsible for lipid transport in breast milk, has been shown to possess immunological and antimicrobial effects. Standard formulas (SF) are devoid of MFGMs during the production process. The study’s aim was to evaluate the safety and benefits of MFGMs supplementation in children. (2) Methods: We searched four databases for randomized controlled trials evaluating the supplementation of MFGMs in children. Growth parameters were chosen as the primary outcome. (3) Results: Twenty-four publications of seventeen studies were included. Meta-analyses assessing the primary outcomes at the age of 4 months included four studies (814 children) comparing the MFGM-supplemented formulas and SF, and two trials (549 children) comparing the MFGM-supplemented formulas and breastfeeding. The primary outcomes were non-inferior in all the experimental MFGM formulas compared to SF, or even represented more similar results to breastfed infants. The promising effects, including a lower incidence of acute otitis media and improved cognitive development, cannot be firmly confirmed due to the small amount of existing evidence. No significant adverse effects were reported in any of the assessed products. (4) Conclusions: The available data signaled beneficial effects and a good safety profile, requiring future research with well-designed trials.
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48
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Anderson CE, Martinez CE, Ventura AK, Whaley SE. Potential overfeeding among formula fed Special Supplemental Nutrition Program for Women, Infants and Children participants and associated factors. Pediatr Obes 2020; 15:e12687. [PMID: 32558255 DOI: 10.1111/ijpo.12687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides enough formula to meet the known nutritional needs of infants up to 6 months of age whose mothers report not breastfeeding, but many mothers report WIC providing insufficient formula, indicating potential overfeeding. OBJECTIVE To estimate the prevalence of potential overfeeding among formula-feeding WIC participants and identify associated factors. METHODS Potential overfeeding was identified among participants of the longitudinal Infant and Toddler Feeding Practices Study-2 (ITFPS-2) receiving the fully formula-feeding WIC infant package at 1 month of age (n = 1235, weighted n = 197 079). Associations of potential overfeeding with caloric intake, weight and participant characteristics were assessed. RESULTS Potential overfeeding was identified among 37.41% (95% CI = 33.57-41.25%) of fully formula-feeding infants. Potentially overfed infants were 0.18 kg heavier (P-value = .01), consumed 26 more calories daily (P-value = .004) and were more likely Non-Hispanic White or English-speaking Hispanic (P-value = .007) and highly active at 5 months of age (P-value = .01). Mothers of potentially overfed infants were less likely to agree that breastfeeding is easier than bottle feeding, only mothers can feed breastfed infants, turning away from the bottle indicates satiation, and crying always indicates hunger (P-values .04, .002, .04 and .04 respectively), and more likely to report WIC provides insufficient formula early (1-5 months, P-value <.0001) and late (6-13 months, P-value = .007) in infancy. CONCLUSIONS Potential overfeeding occurs in 37% of fully formula-feeding infant WIC-participants <6 months old. Mothers of these infants may benefit from additional education about the formula needs of their infants and how to recognize infant satiation cues.
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Affiliation(s)
- Christopher E Anderson
- Department of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, Irwindale, California, USA
| | - Catherine E Martinez
- Department of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, Irwindale, California, USA
| | - Alison K Ventura
- Department of Kinesiology and Public Health, College of Science and Mathematics, California Polytechnic State University, San Luis Obispo, California, USA
| | - Shannon E Whaley
- Department of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, Irwindale, California, USA
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49
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Lindholm A, Bergman S, Alm B, Bremander A, Dahlgren J, Roswall J, Staland-Nyman C, Almquist-Tangen G. Nutrition- and feeding practice-related risk factors for rapid weight gain during the first year of life: a population-based birth cohort study. BMC Pediatr 2020; 20:507. [PMID: 33148198 PMCID: PMC7643358 DOI: 10.1186/s12887-020-02391-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/14/2020] [Indexed: 11/23/2022] Open
Abstract
Background Rapid weight gain (RWG) during infancy increases the risk of excess weight later in life. Nutrition- and feeding practices associated with RWG need to be further examined. The present study aimed to examine nutrition- and feeding practice-related risk factors for RWG during the first year of life. Methods A population-based longitudinal birth cohort study of 1780 infants, classified as having RWG or non-RWG during 0–3-4, 0–6 and 6–12 months. RWG was defined as a change > 0.67 in weight standard deviation scores. Associations between nutrition- and feeding practice-related factors and RWG were examined with logistic regression models. Results Of the participating infants, 47% had RWG during 0–3-4 months, 46% during 0–6 months and 8% during 6–12 months. In the fully adjusted models, bottle-feeding at birth and at 3–4 months and nighttime meals containing formula milk were positively associated with RWG during 0–3-4 months (p < 0.05 for all). Breastfeeding at 3–4 months and nighttime meals containing breast milk were negatively associated with RWG during this period (p < 0.001). Bottle-feeding at birth, 3–4 and 6 months and nighttime meals containing formula milk at 3–4 months were positively associated with RWG during 0–6 months (p < 0.01 for all). Breastfeeding at 3–4 and 6 months was negatively associated with RWG (p < 0.01). During 6–12 months, only bottle-feeding at 3–4 months was positively associated with RWG (p < 0.05). Conclusions RWG was more common during the first 6 months of life and bottle-feeding and formula milk given at night were risk factors for RWG during this period. Supplementary information Supplementary information accompanies this paper at 10.1186/s12887-020-02391-4.
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Affiliation(s)
- Annelie Lindholm
- School of Health and Welfare, Halmstad University, Kristian IV:s väg 3, 301 18, Halmstad, Sweden. .,Research and Development Center Spenshult, Halmstad, Sweden.
| | - Stefan Bergman
- Research and Development Center Spenshult, Halmstad, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bernt Alm
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Bremander
- Research and Development Center Spenshult, Halmstad, Sweden.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefine Roswall
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Pediatrics, Halland Hospital, Halmstad, Sweden
| | - Carin Staland-Nyman
- School of Health and Welfare, Halmstad University, Kristian IV:s väg 3, 301 18, Halmstad, Sweden
| | - Gerd Almquist-Tangen
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Child Health Care Unit, Region Halland, Halmstad, Sweden
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50
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Tahir MJ, Ejima K, Li P, Demerath EW, Allison DB, Fields DA. Associations of breastfeeding or formula feeding with infant anthropometry and body composition at 6 months. MATERNAL AND CHILD NUTRITION 2020; 17:e13105. [PMID: 33145993 PMCID: PMC7988875 DOI: 10.1111/mcn.13105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 09/14/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
The objective of this study was to investigate the associations of mode of feeding with infant anthropometric and body composition variables at 6 months of age. We studied 259 infants whose exclusive mode of feeding (breast or formula) to 1 month was confirmed. Standard anthropometric characteristics of the infants (weight, length and weight‐for‐length z scores) were obtained, and body composition (total fat mass, fat‐free mass, trunk fat mass and body fat percent) was measured using dual‐energy X‐ray absorptiometry (DXA) at 6 months (±12 days). General linear models were used to test the associations of mode of feeding with infant anthropometric and body composition variables at 6 months after adjustment for maternal and infant covariates. In this cohort of predominantly breastfed, White infants of highly educated mothers, fat‐free mass was lower (P = .002), and trunk fat mass (P = .032) and body fat percent (P < .001) were greater in breastfed infants than in formula‐fed infants at 6 months of age. After adjustment for covariates, total fat‐free mass was significantly lower (β = −372 g, [SE = 125, P = .003]), and body fat percent was significantly greater (β = 3.30, [SE = 0.91, P < .001]) in breastfed infants than in formula‐fed infants. No other significant associations were observed. These findings support those of previous studies reporting greater fat‐free mass in formula‐fed infants during the first 6 months of life. Additional research is warranted to explore whether differences in infant body composition by mode of feeding persist throughout the life course and to assess causality.
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Affiliation(s)
- Muna J Tahir
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Keisuke Ejima
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA.,Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Peng Li
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - David A Fields
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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