Beliefs About Infant Growth may Determine Childhood Obesity

Regular readers are well aware of the accumulating evidence that early childhood influences may play a major role in the development of childhood and adult obesity.

Many of these influences may result from parental response to infant temperament and parental perception of infant growth and appetite.

These issues were further explored by Sarah Redsell and colleagues from the University of Nottingham, UK, in a paper just published in BMC Public Health.

The researchers conducted six focus groups in 38 parents (36 female, 2 male), age range 19-45 years, of infants less than one year of age. Parents were selected from different demographic groups. Twelve parents were overweight and eight were obese.

Five main themes were identified:

a) parental concern about breast milk, infant contentment and growth;

b) the belief that the main cause of infant distress is hunger is widespread and drives inappropriate feeding;

c) rationalisation for infants’ larger size;

d) parental uncertainty about identifying and managing infants at risk of obesity;

e) intentions and behaviour in relation to a healthy lifestyle.

A common problem was that parents panicked or felt inadequate when the growth curves of their infants fell below the growth charts, even though the kids appeared otherwise healthy and content.

On the other hand, other parents expressed a sense of fulfillment when their infants gained large amounts of weight according to the centile charts. In particular, parents of premature infants had a strong desire for them to catch up to perceived norms, which was endorsed by others in the group.

Overweight or obese parents appeared biased towards larger babies and believed that having a bigger infant was healthier.

Mothers were quite defensive about any suggestion that their infant might be overweight or growing too quickly and found it easy to justify their infant’s size amongst themselves but feared criticism from others, such as health professionals, family or peers. Parents were not keen on the idea of restricting diet during infancy even for very large infants but thought that that dietary content and quality could be explored by health professionals.

Interestingly, several parents commented on the negative influence of grandparents (a topic I have previously blogged about). Although parents admitted it was grandparents’ prerogative to indulge their grandchild but when this extended to family mealtimes they reported feeling they had lost control of their infant’s diet. Overall, there was a stronger preference for larger infants amongst older family members.

This study clearly shows that there are a number of barriers to early intervention with parents of infants at risk of developing obesity but also that parents appear receptive to prevention prior to weaning.

Specifically, parents would likely benefit from better understanding the physiology of breast feeding, how to differentiate between infant distress caused by hunger and other causes, and the timing of weaning.

In addition some parents appear to need guidance to recognize and prepare healthy foods and facilitate physical activity for their infants.

Clearly, parenting support that focusses on raising healthy infants could play a major role in the prevention of subsequent childhood and adult obesity.

AMS
Edmonton, Alberta

Redsell SA, Atkinson P, Nathan D, Siriwardena AN, Swift JA, & Glazebrook C (2010). Parents’ beliefs about appropriate infant size, growth and feeding behaviour: implications for the prevention of childhood obesity. BMC public health, 10 (1) PMID: 21087482