Efforts to prevent obesity among low-income
infants should focus not only on what babies are being fed but also the reasons
behind unhealthy feeding practices, according to a study presented at the
Pediatric Academic Societies (PAS) annual meeting in Boston.
Adding
cereal to bottles is one unhealthy practice that is discouraged by the American
Academy of Pediatrics because it may lead to overfeeding and excess weight gain
in infants.
Researchers
sought to determine factors associated with putting cereal in bottles among
low-income, primarily Latino households in which the risk forchild obesity is
high.
Mothers of 254 infants
were asked if they ever added cereal to bottles to help their babies sleep
longer or stay full longer. Researchers also collected information on mothers'
age, language, country of origin, marital status, education and income; whether
the mother had symptoms of depression; and infants' age, gender and whether the
infant was felt to have strong emotional reactions (a high intensity
temperament).
The
data were collected as part of the larger Bellevue Project for Early Language,
Literacy and Education Success (BELLE Project). Funded by the National
Institutes of Health/National Institute of Child Health and Human Development,
the BELLE Project is following infants from birth to
first grade to study issues related to parenting and child development.
Results
showed that 24 percent of mothers put cereal in bottles. Those with depressive
symptoms were 15 times more likely to add cereal than mothers who did not
have symptoms
of depression.
"Depression
is very common in low-income mothers and makes it more difficult to engage in
beneficial parenting practices in general," said lead author and general
academic pediatrics fellow Candice Taylor Lucas, MD, MPH, who also is the Alan
Mendelsohn, MD, principal investigator and associate professor of pediatrics,
New York University School of Medicine and Bellevue Hospital Center.
"Our results are especially concerning because
they suggest that depressed mothers may be more likely to add cereal to the
bottle, which may increase their children's risk of obesity."
Data
also showed that mothers who were single were significantly more likely to add
cereal to bottles.
"This
suggests that mothers' support systems and family dynamics may influence feeding practices,"
said obesity researcher and fellow investigator Mary Jo Messito, MD, FAAP.
Mothers
who felt that their children had intense emotional reactions to daily routines
were 12 times more likely to add cereal to bottles.
"Overall,
these findings demonstrate that stressors prevalent in low-income households,
such as depression, single parenthood and associated infant behavioral
challenges, influence feeding practices likely to promote obesity," Dr.
Lucas concluded.
"It
is important to provide support for parents related to healthy feeding
practices if we are to end the epidemic of childhood obesity."
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