Does maternal feeding restriction lead to childhood obesity in a prospective cohort study?
S L Rifas-Shiman1, B Sherry, K Scanlon
1Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA. sheryl_rifas@hphc.org
Insights
Maternal feeding restriction at age 1 was linked to higher child BMI at age 3. This association disappeared after accounting for infant weight, suggesting parents may restrict intake of already overweight infants.
Area of Science:
- Pediatric Nutrition
- Childhood Obesity Research
- Maternal Health
Background:
- Parental feeding practices influence child weight trajectories.
- Previous research suggests a link between parental control and childhood obesity.
- The role of parental reaction to infant weight status remains unclear.
Purpose of the Study:
- To investigate the longitudinal association between maternal feeding restriction at age 1 and body mass index (BMI) at age 3.
- To determine if infant weight for length (WFL) at age 1 explains this association.
- To analyze the predictive relationship between early feeding behaviors and later obesity markers.
Main Methods:
- Prospective cohort study of 837 mother-infant pairs.
- Maternal feeding restriction assessed via questionnaire at age 1.
- Multivariable linear regression models used, adjusting for sociodemographic factors and WFL at age 1.
Main Results:
- 12% of mothers reported feeding restriction at age 1.
- Maternal feeding restriction was associated with higher BMI z-score at age 3 before adjustment for WFL.
- The association between feeding restriction and BMI at age 3 was not significant after adjusting for WFL at age 1.
Conclusions:
- Maternal feeding restriction at age 1 is not independently associated with higher BMI at age 3.
- Infant WFL at age 1 appears to mediate the relationship between maternal feeding restriction and child BMI at age 3.
- Findings suggest parental feeding restriction may be a response to, rather than a cause of, infant overweight status.
Background:
Some studies show that greater parental control over children's eating habits predicts later obesity, but it is unclear whether parents are reacting to infants who are already overweight.
Objective:
To examine the longitudinal association between maternal feeding restriction at age 1 and body mass index (BMI) at age 3 and the extent to which the association is explained by weight for length (WFL) at age 1.
Methods:
We studied 837 mother-infant pairs from a prospective cohort study. The main exposure was maternal feeding restriction at age 1, defined as agreeing or strongly agreeing with the following question: "I have to be careful not to feed my child too much." We ran multivariable linear regression models before and after adjusting for WFL at age 1. All models were adjusted for parental and child sociodemographic characteristics.
Results:
100 (12.0%) mothers reported feeding restriction at age 1. Mean (SD) WFL z-score at age 1 was 0.32 (1.01), and BMI z-score at age 3 was 0.43 (1.01). Maternal feeding restriction at age 1 was associated with higher BMI z-score at age 3 before (β 0.26 (95% CI 0.05 to 0.48)) but not after (β 0.00 (95% CI -0.17 to 0.18)) adjusting for WFL z-score at age 1. Each unit of WFL z-score at age 1 was associated with an increment of 0.57 BMI z-score units at age 3 (95% CI 0.51 to 0.62).
Conclusions:
We found that maternal feeding restriction was associated with children having a higher BMI at age 3 before, but not after, adjusting for WFL at age 1. One potential reason may be that parents restrict the food intake of infants who are already overweight.
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