Feeding practices play a central role in infants’ rapid weight gain, UNC Greensboro researchers find

A UNC Greensboro (UNCG) study following 299 women and their infants from pregnancy to toddlerhood examined mul ple psychological, biological, and social factors in the context of infants’ rapid weight gain. They found infant feeding practices associated with obesity, known as obesogenic practices, are strongly correlated with rapid infant weight gain.  

Examples of obesogenic practices described in their recent Pediatric Obesity paper include watching television while feeding a baby, formula feeding, and supplementing a bottle with additional foods.  

“The key take home point is that what and how parents feed their infants in the first 6 months of life has tremendous implications for obesity risk, and childbearing parents who experience more stress during the prenatal period are particularly likely to engage in these unhealthy pratices,” says Dr. Esther Leerkes, a UNCG professor in human development and family studies, who served as lead author on the paper. Coauthors included Dr. Cheryl Buehler, Dr. Laurie Wideman in kinesiology, Dr. Lenka Shriver in nutrition, and graduate student Yu Chen.

Infants who gain weight rapidly before the age of two are at a higher risk for obesity. Given that the childhood obesity epidemic has not yet abated – over 37 million children across the world are obese – scientists are parsing out which behaviors and practices are spurring infants’ rapid weight gain.

This study is the most recent publication from UNCG’s NIH-funded Infant Growth and Development (iGrow) study – a $2.8 million longitudinal research program to better understand children’s obesity risk by tracking infants’ biological and social development from before birth un l age two. The first aim of the iGrow study focused on determining the main predictors of infants’ rapid weight gain by studying infants from before birth to approximately 6-months of age.

Researchers recruited 299 pregnant women and measured their physical and psychological health, known as prenatal psychobiological risk. Strengths of their sample include the diverse backgrounds and socioeconomic statuses of par cipants: 29.4% identified as Black, 6.7% as multiracial, and 7.7% as Hispanic or Latino.  

Once participants gave birth, researchers assessed caregivers’ attunement to infant needs (maternal sensitivity), infant temperament and stress level (psychobiological risk), and obesogenic feeding practice at set intervals.

The researchers discovered obesogenic feeding practices strongly and significantly correlated with infant rapid weight gain, and that mothers’ prenatal psychological risk increased the likelihood they would engage in obesogenic feeding. But, to their surprise, they found infants’ psychobiological risk was not significantly associated with rapid weight gain when considered within a broader model with feeding practices.  

“Usually in research, we are most interested in what associations are statiscally significant,” Leerkes says. “In this case, the ones that were not were also of interest.”

While the findings highlight the importance of parents reducing obesogenic practices, she says it is important to understand barriers families may face with infant feeding. 

“Parenting a baby is so challenging. Parents are frequently exhausted and overtaxed between family and work commitments and ongoing stressors, and they are presented with lots of informa on which can be hard to weed through,” she says.  

Although Leerkes says breastfeeding is recommended to decrease obesity risk, some parents may not have this option due to me constraints, physical limitations, or other systemic level barriers.  

“A variety of factors, including cultural and socio-environmental, can make it difficult for some women to breastfeed their babies,” says Shriver. “Our findings show that new parents can still prevent excessive weight gain in the first few months of their child's life even if breastfeeding is not a realistic option for them.”

They recommend parents who are bottle feeding stay attuned to their baby, including watching for signs their baby could be full, observing suckling rate, and turning off the television. They also advise parents to avoid adding cereal, juice, or baby food to a bottle and to try not to use a bottle to soothe a baby that is not hungry.

The new publication represents the first set of findings testing one of iGrow’s primary aims, and the researchers look forward to many more to come.  

With an additional $3 million in NIH funding, the iGrow study recently expanded to include iGrowUP. Now, UNCG researchers can follow the par cipants all the way to the age of five, giving them a unique, longitudinal vantage point into obesity risk throughout infancy and early childhood.