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Racial and ethnic differences associated with feeding- and activity-related behaviors in infants
Eliana M Perrin1, Russell L Rothman, Lee M Sanders
1Department of Pediatrics, School of Medicine, and.
Insights
Parental feeding and activity behaviors in 2-month-olds vary significantly by race/ethnicity. These early childhood obesity risk factors highlight the need for culturally tailored interventions.
Area of Science:
- Pediatric Health
- Obesity Prevention
- Behavioral Science
Background:
- Early life feeding and activity patterns are critical determinants of childhood obesity.
- Parental behaviors in the first few months of life can establish long-term health trajectories.
- Understanding disparities in these behaviors across racial/ethnic groups is essential for targeted interventions.
Purpose of the Study:
- To investigate feeding and activity behaviors in parents of 2-month-old infants.
- To analyze how these behaviors differ among parents of various racial/ethnic backgrounds.
- To identify potential risk factors for early childhood obesity based on parental reports.
Main Methods:
- A cohort of 863 parents from a cluster, randomized obesity prevention trial (Greenlight) were surveyed at enrollment.
- Data collected included infant feeding practices (breastfeeding, formula feeding, solid introduction), bottle-feeding habits, and television exposure.
- Statistical analyses, including Pearson chi-squared, Kruskal-Wallis, and proportional odds logistic regressions, were used to assess associations between race/ethnicity and behaviors.
Main Results:
- High prevalence of behaviors associated with obesity risk was observed, including formula feeding (45%), bottle propping (23%), and excessive television exposure (mean 346 min/day).
- Compared to white parents, black parents showed higher rates of bottle-to-bed (aOR=1.97) and bottle propping (aOR=3.1).
- Hispanic parents reported increased encouragement to finish feeding (aOR=1.9), bottle propping (aOR=2.5), and less recommended "tummy time" (aOR=0.6) compared to white parents.
Conclusions:
- Behaviors linked to later obesity are common in diverse infant populations.
- Significant racial/ethnic variations in these early feeding and activity behaviors were identified.
- Culturally adapted, early intervention strategies are crucial for addressing obesity disparities.
Objective:
To examine parental reports of feeding and activity behaviors in a cohort of parents of 2-month-olds and how they differ by race/ethnicity.
Methods:
Parents participating in Greenlight, a cluster, randomized trial of obesity prevention at 4 health centers, were queried at enrollment about feeding and activity behaviors thought to increase obesity risk. Unadjusted associations between race/ethnicity and the outcomes of interest were performed by using Pearson χ(2) and Kruskal-Wallis tests. Adjusted analyses were performed by using proportional odds logistic regressions.
Results:
Eight hundred sixty-three parents (50% Hispanic, 27% black, 18% white; 86% Medicaid) were enrolled. Exclusive formula feeding was more than twice as common (45%) as exclusive breastfeeding (19%); 12% had already introduced solid food; 43% put infants to bed with bottles; 23% propped bottles; 20% always fed when the infant cried; 38% always tried to get children to finish milk; 90% were exposed to television (mean, 346 minutes/day); 50% reported active television watching (mean, 25 minutes/day); and 66% did not meet "tummy time" recommendations. Compared with white parents, black parents were more likely to put children to bed with a bottle (adjusted odds ratio [aOR] = 1.97, P < .004; bottle propping, aOR = 3.1, P < .001), and report more television watching (aOR = 1.6, P = .034). Hispanic parents were more likely than white parents to encourage children to finish feeding (aOR = 1.9, P = .007), bottle propping (aOR = 2.5, P = .009), and report less tummy time (aOR = 0.6, P = .037).
Conclusions:
Behaviors thought to relate to later obesity were highly prevalent in this large, diverse sample and varied by race/ethnicity, suggesting the importance of early and culturally-adapted interventions.
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