Related Experiment Video
Updated: Aug 1, 2025
Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling
Published on: February 5, 2019
The Baby Bites Text Messaging Project with randomized controlled trial: texting to improve infant feeding practices
Kathleen E Davis1, Adyson Klingenberg1, Marilyn Massey-Stokes2
1Department of Nutrition and Food Sciences, Texas Woman's University, Denton, TX, USA.
Insights
Preventing childhood obesity is crucial. A pilot study found text message interventions did not significantly change infant weight or feeding practices compared to usual care, suggesting a need for flexible messaging strategies.
Area of Science:
- Pediatric Health
- Obesity Prevention
- Public Health Interventions
Background:
- Rapid infant weight gain and overweight are linked to childhood obesity.
- Effective, accessible interventions are needed to promote healthy infant feeding practices.
- Early obesity prevention strategies are essential for long-term health outcomes.
Purpose of the Study:
- To explore parental attitudes towards infant feeding and early obesity.
- To pilot a randomized controlled trial (RCT) comparing text message interventions to usual care for preventing early pediatric obesity.
- To assess the feasibility and impact of text message-based interventions on infant feeding practices and weight gain.
Main Methods:
- A mixed-methods study combining qualitative interviews with parents and a pilot RCT.
- Qualitative interviews explored parental feeding attitudes and communication with pediatricians.
- The RCT involved 38 parents, comparing 12 months of text messages promoting healthy feeding to usual care, with measurements of weight-for-length and feeding practices.
Main Results:
- No significant differences were found between the intervention and control groups in weight-for-length percentile or z-scores.
- Breastfeeding persistence and the age of introduction of solids also showed no significant differences.
- Low survey response rates limited the study's statistical power.
Conclusions:
- Text messaging shows potential for extending healthcare provider communication beyond the clinic.
- Intervention flexibility is crucial to address barriers like service loss and message customization.
- Further research is needed to optimize text messaging strategies for infant obesity prevention.
Background:
Rapid weight gain and overweight in infancy are associated with childhood obesity. Thus, effective, accessible interventions to promote healthy infant feeding practices to prevent early obesity are essential.
Methods:
This mixed-methods study involved diverse parents of infants in an urban, low-income pediatric clinic. Qualitative interviews explored parental attitudes towards feeding, early obesity, and communication with the pediatrician. A pilot, randomized controlled trial (RCT) informed by feedback provided by clinic parents compared text messages delivered for 12 months promoting healthy feeding practices to usual care to prevent early pediatric obesity. A computer-generated randomization schedule with balanced distribution for sex was used to place infants into groups. Weight-for-length percentiles and z-scores and feeding practices were measured at 0-2 weeks (baseline), 2-4 months, 6-9 months, and 12 months. Interviews were recorded, transcribed, and coded using thematic analysis. Weight for length percentile, Weight for length z scores, and feeding practices were compared between groups using repeated measures mixed analysis of variance (ANOVA).
Results:
Participants in the interviews were 15 parents of infants less than 1 month old. RCT participants were 38 parents of newborns (17 control; 21 intervention). Most parents in the qualitative evaluation viewed breastfeeding positively but also discussed barriers. Most also wanted practical information regarding infant feeding. There were no differences in weight-for-length percentile (F=0.52; P=0.60) or z-scores (F=0.7922; P=0.79), breastfeeding persistence χ2[1] =1.45, P=0.23, or age of introduction of solids in the intervention (statistical analysis not possible due to low counts) compared to the control group; however, low response to surveys limited the study's power.
Conclusions:
Text messaging has potential to extend the healthcare provider's communication beyond clinic. However, texting interventions should be flexible to mitigate barriers such as loss of phone service and challenges customizing messages to parent needs.
