Obesity During Infancy

Many parents involved in a new study reported infant feeding, television, and physical-activity practices that could increase their children’s risk of obesity. Researchers say the study's results, which were published online today in the journal Pediatrics, highlight the importance of the parents’ contributions during the first few months of an infant’s life.

“These results from a large population of infants—especially the high rates of television watching—teach us that we must begin obesity prevention even earlier,” said Dr. Eliana M. Perrin, lead author of the study and associate professor of pediatrics at the University of North Carolina School of Medicine, in a press release.

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Potential Obesity-Related Activities Common

The study included 863 parents and their infants, who were between the ages of 6 and 16 weeks. The families were recruited from four university-affiliated pediatric clinics. More than two-thirds of the participants were from low-income families. A questionnaire given to parents at their infant’s regular two-month health visit showed that feeding practices thought to contribute to later obesity in children were quite common.

Feeding infants only formula was more than twice as common as breastfeeding exclusively, 45 percent compared with 19 percent. Also, 12 percent of parents fed their infants solid foods earlier than recommended—although only 3 percent fed them sugar-sweetened drinks.

Almost half of parents reported putting their infant to bed with a bottle, and 23 percent propped up the bottle instead of holding it by hand while the child fed. Also, 38 percent of parents always tried to get their infant to finish the full bottle of formula or breast milk, and 20 percent fed their infant whenever he or she cried. Experts recommend against these practices.

In addition, 90 percent of children were exposed to television, on average more than five hours per day. Also, half of infants actively watched television—being placed in front of the TV by their parents—on average 25 minutes per day.

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Guidelines Support Healthy Parenting Activities

While the researchers focused on specific parental activities, Tara Harwood, a registered dietician with the Cleveland Clinic, emphasizes that more research is needed to better understand how feeding practices for infants contribute to the risk of obesity later in the child’s life.

However, she says that several parenting practices are recommended by organizations such as the American Academy of Pediatrics (AAP). These include breastfeeding exclusively for about six months, followed by introduction of solid foods alongside breast milk. The AAP also suggests that television and other media be limited during the first two years of a child’s life.

In addition, a new study in JAMA Pediatrics emphasizes the importance of parental involvement during later years. Among 213 children, 7-year-olds whose mothers spent less time monitoring their time spent watching TV or playing video games had higher body mass index, a sign of being overweight or obese.

Unfortunately, guidelines for parents are never as clear in the real world of crying infants and chaotic work schedules. Harwood suggests that parents work with their pediatrician and obstetrician to learn what to expect during their infant’s first few months, especially when it comes to feeding.

It may also mean that parents change their own behaviors, such as breastfeeding exclusively for longer, watching less TV when the child is around, or learning to recognize the child’s hunger cries.

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Parental Practices Differ Among Ethnic Groups

In addition to seeing how common certain parenting practices were in general, researchers found differences, both beneficial and potentially harmful, among racial and ethnic groups.

For example, black parents were more likely to encourage “tummy time,” which provides regular play for the infant and helps develop the muscles of the neck. However, these parents were also more likely to report letting the infant watch TV and putting him or her to bed with a bottle, both of which may contribute to later obesity.

On the other hand, Hispanics were less likely to feed their infants formula and solids, but tended to encourage their child to finish the bottle of formula or breast milk almost every time, regardless of the infant’s hunger.

The researchers write that their findings could be used to help develop ways to educate parents that better fit their culture. More research, though, is needed to determine whether cultural differences or family history plays a larger role in encouraging activities that promote a child’s health.

"What this study taught us is that we can do better,” said Perrin. “While we don't know the exact causes of obesity, families of all races and ethnicities need early counseling to lead healthier lives. That counseling should be culturally tailored, and we are hoping our research sheds light on the best ways to do that.”