Twelve-Month Outcomes of the First 1000 Days Program on Infant Weight Status
Elsie M Taveras1,2,3, Meghan E Perkins2, Alexy Arauz Boudreau2
1The Kraft Center for Community Health elsie.taveras@mgh.harvard.edu.
Insights
The First 1000 Days intervention improved infant weight status and maternal postpartum care. This early-life program reduced infant overweight prevalence and increased postpartum visit completion for mothers.
Area of Science:
- Public Health
- Pediatrics
- Maternal Health
Background:
- Infant overweight and maternal postpartum weight retention are significant public health concerns.
- Early life interventions during the first 1000 days are critical for long-term health outcomes.
Purpose of the Study:
- To evaluate the impact of the First 1000 Days intervention on infant overweight and maternal postpartum weight retention and care.
- To assess the effectiveness of a community health center-based program incorporating staff training, growth tracking, and health coaching.
Main Methods:
- A quasi-experimental design was used, comparing 995 infants and mothers in intervention centers with 650 dyads in comparison centers.
- Infant outcomes (weight-for-length z-score, overweight status) were assessed at 6 and 12 months.
- Maternal outcomes included weight retention and postpartum visit completion at 6 weeks.
Main Results:
- Infants in the intervention group showed significantly lower weight-for-length z-scores and reduced odds of overweight at 6 and 12 months.
- Mothers in the intervention group had higher odds of completing their postpartum visit.
- Maternal weight retention was modestly lower but not statistically significant in the intervention group.
Conclusions:
- The First 1000 Days intervention, combining systems change and coaching, effectively improved infant weight status.
- The intervention also positively impacted maternal postpartum care, specifically increasing postpartum visit completion.
Objectives:
To examine the effects of the First 1000 Days intervention on the prevalence of infant overweight and maternal postpartum weight retention and care.
Methods:
Using a quasi-experimental design, we evaluated the effects of the First 1000 Days program among 995 term, low-income infants and their mothers receiving care in 2 intervention community health centers and 650 dyads in 2 comparison health centers. The program includes staff training, growth tracking, health and behavioral screening, patient navigation, text messaging, educational materials, and health coaching. Comparison centers implemented usual care. Infant outcomes were assessed at 6 and 12 months, including weight-for-length z score and overweight (weight for length ≥97.7th percentile). We also examined maternal weight retention and receipt of care 6 weeks' post partum.
Results:
The mean birth weight was 3.34 kg (SD 0.45); 57% of infants were Hispanic; 66% were publicly insured. At 6 months, infants had lower weight-for-length z scores (β: -.27; 95% confidence interval [CI]: -.39 to -.15) and lower odds of overweight (adjusted odds ratio [OR]: 0.46; 95% CI: 0.28 to 0.76) than infants in comparison sites; differences persisted at 12 months (z score β: -.18; 95% CI: -.30 to -.07; adjusted OR for overweight: 0.60; 95% CI: 0.39 to 0.92). Mothers in the intervention sites had modestly lower, but nonsignificant, weight retention at 6 weeks' post partum (β: -.51 kg; 95% CI: -1.15 to .13) and had higher odds (adjusted OR: 1.50; 95% CI: 1.16 to 1.94) of completing their postpartum visit compared with mothers in the comparison sites.
Conclusions:
An early-life systems-change intervention combined with coaching was associated with improved infant weight status and maternal postpartum care.
Related Concept Videos
01:24Obesity
01:52Regression Toward the Mean
01:30Socioemotional Development during Infancy
Primary Temperament Types
01:29Drug Dosing: Infants and Children
01:29Environmental Influences on Intelligence