Randomized Controlled Trial of a Primary Care-Based Child Obesity Prevention Intervention on Infant Feeding Practices

J Pediatr. 2016 Jul;174:171-177.e2. doi: 10.1016/j.jpeds.2016.03.060. Epub 2016 Apr 21.

Abstract

Objective: To determine the effects of a child obesity prevention intervention, beginning in pregnancy, on infant feeding practices in low-income Hispanic families.

Study design: The Starting Early randomized controlled trial enrolled pregnant women at a third trimester visit. Women (n = 533) were randomly allocated to a standard care control group or an intervention group participating in prenatal and postpartum individual nutrition/breastfeeding counseling and subsequent nutrition and parenting support groups coordinated with well-child visits. Outcome measures included infant feeding practices and maternal infant feeding knowledge at infant age 3 months, using questions adapted from the Infant Feeding Practices Study II and an infant 24-hour diet recall.

Results: A total of 456 families completed 3-month assessments. The intervention group had higher prevalence of exclusive breastfeeding on the 24-hour diet recall (42.7% vs 33.0%, P = .04) compared with controls. The intervention group reported a higher percentage of breastfeeding vs formula feeding per day (mean [SD] 67.7 [39.3] vs 59.7 [39.7], P = .03) and was less likely to introduce complementary foods and liquids compared with controls (6.3% vs 16.7%, P = .001). The intervention group had higher maternal infant feeding knowledge scores (Cohen d, 0.29, 95% CI .10-.48). The effect of Starting Early on breastfeeding was mediated by maternal infant feeding knowledge (Sobel test 2.86, P = .004).

Conclusions: Starting Early led to increased exclusive breastfeeding and reduced complementary foods and liquids in 3-month-old infants. Findings document a feasible and effective infrastructure for promoting breastfeeding in families at high risk for obesity in the context of a comprehensive obesity prevention intervention.

Trial registration: ClinicalTrials.gov: NCT01541761.

Keywords: Hispanic; feeding knowledge; pregnancy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Breast Feeding*
  • Directive Counseling*
  • Female
  • Health Knowledge, Attitudes, Practice / ethnology
  • Hispanic Americans
  • Humans
  • Infant
  • Infant Care*
  • Infant, Newborn
  • Male
  • Pediatric Obesity / ethnology
  • Pediatric Obesity / prevention & control*
  • Poverty
  • Pregnancy
  • Prenatal Care
  • Primary Health Care*
  • Primary Prevention / methods*

Associated data

  • ClinicalTrials.gov/NCT01541761