Identifying elevated child weight from 3 to 24 months: Early transitions into nonparental care and to solid foods

Area of Science:

• Child development
• Pediatric nutrition
• Public health

Background:

• Early entry into nonparental care (NPC) and introduction to solid foods (ITS) are independently associated with increased child weight.
• Limited research has explored the combined impact of these early life transitions on long-term child weight trajectories.

Purpose of the Study:

• To identify distinct groups of infants based on the timing of NPC and ITS.
• To investigate whether these identified NPC-ITS groups differentially influence child weight-for-length/height z-scores (WFL/WFHz) from 3 to 24 months of age.

Main Methods:

• Utilized data from the STRONG Kids2 cohort (n=468).
• Classified children into groups based on NPC type (parental, daycare, kincare) and timing of ITS (before or after 6 months).
• Employed multilevel regression to analyze the association between NPC-ITS groups and child WFL/WFHz over time.

Main Results:

• Six distinct NPC-ITS groups were identified, with significant variations in the timing of care and food introduction.
• Children in daycare (any ITS timing) or kincare with ITS before 6 months exhibited significantly higher WFL/WFHz compared to those primarily in parental care.
• These differences in weight-for-length/height z-scores persisted throughout the first two years of life.

Conclusions:

• The combination of nonparental care and the timing of solid food introduction significantly impacts infant weight trajectories.
• A collaborative approach between parental and nonparental caregivers is crucial for supporting optimal infant feeding practices during the transition to solid foods.
• Interventions should consider the type and timing of nonparental care in conjunction with feeding practices to mitigate risks of elevated child weight.