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Coordination Between Primary Care and Women, Infants, and Children to Prevent Obesity for Infants from Low-Income
Jennifer S Savage1, Amy M Moore1, Samantha M R Kling2
1Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, USA.
Insights
A responsive parenting intervention did not reduce rapid infant weight gain but modestly lowered infant BMI and reduced mothers' use of food to soothe. This study explored infant weight gain and parenting strategies.
Area of Science:
- Pediatrics
- Public Health
- Behavioral Science
Background:
- Rapid infant weight gain is a risk factor for later obesity.
- Limited research exists on responsive parenting interventions coordinating care between pediatric providers and WIC nutritionists to manage infant weight.
- The Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study addresses this gap.
Purpose of the Study:
- To examine the effect of a patient-centered responsive parenting (RP) intervention on infant weight gain.
- To assess the intervention's impact on infant weight-for-age z scores, BMI, and overweight status up to 6 months.
- To evaluate the intervention's effect on mothers' use of food to soothe infants.
Main Methods:
- A pragmatic, randomized clinical trial involving 288 mothers and infants.
- The intervention utilized advanced health information technology for care coordination between pediatric primary care providers and Women, Infants, and Children (WIC) nutritionists.
- General linear models analyzed intervention effects on infant weight metrics and maternal feeding behaviors from birth to 6 months.
Main Results:
- No significant intervention effects were found on infant conditional weight gain scores or overweight status at 6 months.
- Infants in the RP intervention group showed significantly lower mean weight-for-age z scores and BMI compared to the standard care group.
- Mothers in the RP intervention group reported significantly lower use of food to soothe infants from 2 to 6 months.
Conclusions:
- The patient-centered RP intervention, with coordinated care, did not reduce rapid infant weight gain or overweight status.
- The intervention was associated with modest reductions in infant BMI and decreased maternal use of food for soothing.
- Findings suggest potential benefits for infant weight management and maternal feeding behaviors, warranting further investigation.
Abstract:
Rapid weight gain during infancy is associated with risk for later obesity, yet little research to date has examined the effect of a responsive parenting (RP) intervention with care coordination between pediatric primary care providers and Women, Infants, and Children nutritionists on infant weight. The Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study is a pragmatic, randomized clinical trial for mothers and infants (n = 288) designed to examine the effect of a patient-centered RP intervention that used advanced health information technology strategies to coordinate care to reduce rapid infant weight gain compared with standard care. General linear models examined intervention effects on infant conditional weight gain scores, weight-for-age z scores, BMI, and overweight status (BMI-for-age ≥85th percentile) from birth to age 6 months, and mothers' use of food to soothe from age 2 to 6 months. There were no intervention effects on infant conditional weight gain scores or overweight status at 6 months. Infants in the RP intervention had lower mean weight-for-age z scores [M = -0.04, standard error (SE) = 0.04 vs. M = 0.05, SE = 0.04; p = 0.008] and lower mean BMI (M = 16.05, SE = 0.09 vs. M = 16.24, SE = 0.09; p = 0.03) compared with standard care. Mothers' use of emotion-based food to soothe was lower in the RP intervention compared with standard care from age 2 to 6 months [M difference = -0.32, standard deviation (SD) = 0.81 vs. 0.00, SD = 0.90; p = 0.01]. This pragmatic, patient-centered RP intervention did not reduce rapid infant weight gain or overweight but was associated with modestly lower infant BMI and reduced mothers' use of emotion-based food to soothe. Trial Registration: clinicaltrials.gov identifier: NCT03482908.
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