Cloutier M M, Wiley J F, Kuo C-L, Cornelius T, Wang Z, Gorin A A
Department of Pediatrics UCONN Health, Children's Center for Community Research Connecticut Children's Medical Center, Hartford, CT, USA.
DO Candidate 2019, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
Pediatr Obes. 2018 Nov;13(11):677-685. doi: 10.1111/ijpo.12458. Epub 2018 Aug 28.
Obesity is a major and worldwide health problem in children.
The Early Childhood Obesity Prevention Program is a multi-component, randomized, controlled trial of a pilot community-focused obesity prevention program for mother/newborn dyads.
Underserved, mother/newborn dyads were recruited to receive a standard home visitation program (Nurturing Families Network, NFN) or an enhanced program (NFN+) that incorporated behavioural change strategies (e.g., goal-setting, problem-solving) and focused on six obesity-associated behaviours (breastfeeding, juice/sugar-sweetened beverages, solids, infant sleep, TV/screen time and soothability) with linkages to community resources. Weight-for-length (WFL) z-score and maternal diet were secondary outcomes.
Fifty-seven dyads were recruited and 47 fully eligible dyads were enrolled (NFN = 21, NFN+ = 26). Forty-one (87.2%) were assessed at 6 months and 34 (72.3%) at 12 months. Retention at 12 months was higher for NFN+ dyads (84.6% vs. 56.1%, p = 0.04). NFN+ mothers were more likely to continue breastfeeding at 6 and 12 months vs. NFN mothers (p = 0.03 and 0.003, respectively), and at 12 months, NFN+ infants had fewer nocturnal awakenings (p = 0.04). There were no differences in other primary outcome measures or in WFL z-score at 6 or 12 months.
A multi-component behavioural intervention increased breastfeeding duration and decreased nocturnal awakenings in infants of low-income families.
肥胖是一个影响全球儿童的主要健康问题。
幼儿肥胖预防项目是一项针对母婴二元组的、以社区为重点的试点肥胖预防项目的多组分随机对照试验。
招募服务不足的母婴二元组，使其接受标准的家庭访视项目（养育家庭网络，NFN）或强化项目（NFN+），后者纳入了行为改变策略（如目标设定、问题解决），并聚焦于六种与肥胖相关的行为（母乳喂养、果汁/含糖饮料、固体食物、婴儿睡眠、看电视/屏幕时间和安抚性），且与社区资源相联系。身长体重比（WFL）z评分和母亲饮食是次要结果。
招募了57个二元组，47个完全符合条件的二元组被纳入研究（NFN组=21个，NFN+组=26个）。41个（87.2%）在6个月时接受评估，34个（72.3%）在12个月时接受评估。NFN+二元组在12个月时的保留率更高（84.6%对56.1%，p=0.04）。与NFN组母亲相比，NFN+组母亲在6个月和12个月时更有可能继续母乳喂养（分别为p=0.03和0.003），且在12个月时，NFN+组婴儿夜间醒来次数更少（p=0.04）。在6个月或12个月时，其他主要结局指标或WFL z评分没有差异。
多组分行为干预增加了低收入家庭婴儿的母乳喂养持续时间，并减少了夜间醒来次数。
