Effectiveness of a behavioural intervention to prevent excessive weight gain during infancy (The Baby Milk Trial):
Rajalakshmi Lakshman1, Fiona Whittle2, Wendy Hardeman3
1MRC Epidemiology Unit and UKCRC Centre of Excellence in Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK. rl284@mrc-epid.cam.ac.uk.
Insights
This study investigates a behavioral intervention to reduce formula intake and prevent infant obesity. The findings will inform infant feeding guidelines and the relationship between feeding, behavior, and growth.
Area of Science:
- Pediatrics
- Nutritional Science
- Behavioral Science
Background:
- Infancy is a critical period for growth, habit formation, and obesity prevention.
- Excess infant weight gain is linked to later obesity.
- Formula-fed infants show higher rates of excess weight gain than breastfed infants.
Purpose of the Study:
- To evaluate a behavioral intervention aimed at reducing formula intake and preventing excessive infant weight gain.
- To inform infant feeding guidelines.
- To understand the links between infant feeding, behavior, appetite, and growth.
Main Methods:
- A randomized controlled trial involving 650-700 parents introducing formula within 14 weeks of birth.
- Intervention group received a 6-month behavioral program based on Social Cognitive Theory, focusing on motivation, action, and coping planning.
- Control group received general feeding advice; anthropometric outcomes measured at birth, 6, and 12 months.
Main Results:
- Primary outcome: change in weight standard deviation score from birth to 1 year.
- Secondary outcomes assessed via questionnaires on milk intake, temperament, appetite, sleep, and maternal factors.
- A 4-day food diary was completed at 8 months.
Conclusions:
- The trial results will contribute to evidence-based infant feeding recommendations.
- Findings will enhance understanding of the complex interplay between infant feeding practices, behavioral patterns, appetite regulation, and overall growth trajectory.
Background:
Infancy is a period of rapid growth and habit formation and hence could be a critical period for obesity prevention. Excess weight gain during infancy is associated with later obesity and formula-fed babies are more likely to gain excess weight compared to breastfed babies. The primary trial outcome is a change in the weight standard deviation score from birth to 1 year.
Methods/Design:
We will recruit 650 to 700 parents who introduce formula-milk feeds within 14 weeks of their baby's birth to a single (assessor) blind, parallel group, individually randomised controlled trial. The focus of the intervention is the caregiver (usually the mother), and the focus of the primary outcome is the infant. The intervention group will receive the behavioural intervention, which aims to reduce formula-milk intake, promote responsive feeding and healthy weaning, and prevent excessive weight gain during infancy. The intervention is based on Social Cognitive Theory and action planning ('implementation intentions'). It consists of three components: (1) a motivational component to strengthen parents' motivation to follow the Baby Milk feeding guidelines, (2) an action planning component to help translate motivation into action, and (3) a coping planning component to help parents deal with difficult situations. It will be delivered by trained facilitators (research nurses) over 6 months through three face-to-face contacts, two telephone contacts and written materials. The control group will have the same number of contacts with facilitators, and general issues about feeding will be discussed. Anthropometric outcomes will be measured by trained research staff, blind to group allocation, at baseline, 6 months and 12 months following standard operating procedures. Validated questionnaires will assess milk intake, temperament, appetite, sleep, maternal quality of life and maternal psychological factors. A 4-day food diary will be completed at 8 months.
Discussion:
The results of the trial will help to inform infant feeding guidelines and to understand the links between infant feeding, behaviour, appetite and growth.
Trial Registration:
ISRTCN20814693 . Registration date 13 January 2011.
Related Concept Videos
Operant Conditioning Intervention
In operant conditioning, behaviors that are...
Binge Eating Disorders
Behavior Modification
A real-world application of operant conditioning principles is applied...
Obesity
Regulation of Food Intake
Regression Toward the Mean


