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Randomized Controlled Trial
. 2016 Jul:174:171-177.e2.
doi: 10.1016/j.jpeds.2016.03.060. Epub 2016 Apr 21.

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

Rachel S Gross  1 , Alan L Mendelsohn  2 , Michelle B Gross  3 , Roberta Scheinmann  4 , Mary Jo Messito  3
Affiliations
Randomized Controlled Trial

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

Rachel S Gross et al. J Pediatr. 2016 Jul.

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Participant enrollment and assessment
Figure 2
Figure 2
Path analysis – Maternal Breastfeeding Knowledge Mediates the Relationship between the Starting Early Intervention and Breastfeeding Intensity at 3 monthsa
See this image and copyright information in PMC

Comment in

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