Infant Regulatory Problems and Obesity in Early Childhood

Acad Pediatr. 2017 Jul;17(5):523-528. doi: 10.1016/j.acap.2016.11.001.


Objective: Difficult infant temperament is associated with higher weight status in infancy. However, the association of infant temperament, including regulatory capacities, has not been well studied as a possible predictor of future weight status in early childhood. We examined prospective associations of infant regulatory difficulties with obesity in early childhood in a large, diverse cohort.

Methods: We used data from 5750 children in the Early Childhood Longitudinal Study-Birth Cohort, excluding preterm infants and infants small or large for gestational age. Infant regulatory ability was measured at age 9 months by the Infant Toddler Symptom Checklist (ITSC). We created a multivariable logistic regression model comparing risk of obesity at preschool age in infants with ITSC scores ≥6 to infants with scores <6. We further examined the association when stratified by a measure of maternal sensitivity.

Results: The cohort of children was 48% non-Hispanic white, and 51% were boys. Twenty-one percent of children with ITSC scores ≥6 were obese at preschool age. Infants with ITSC scores ≥6 had 32% increased odds of being obese at preschool age (adjusted odds ratio 1.32 [95% confidence interval 1.03, 1.70]). The strongest association existed among children described as demanding attention constantly. There was no difference in the association when comparing mothers with high or low maternal sensitivity.

Conclusions: Infant regulatory difficulties are associated with a higher risk of obesity at preschool age. Helping parents manage and respond to difficult infant behaviors before preschool may serve as a focal point for future interventions.

Keywords: infant; obesity; regulation.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Child, Preschool
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Male
  • Pediatric Obesity / epidemiology*
  • Risk Factors
  • Sensitivity and Specificity
  • Symptom Assessment
  • Temperament*