An early feeding practices intervention for obesity prevention

Lynne Daniels, Kimberley Mallan, Jan Nicholson, Karen Thorpe, Smita Nambiar, Chelsea Mauch, Anthea Magarey

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    OBJECTIVE: Report long-term outcomes of the NOURISH randomized controlled trial (RCT), which evaluated a universal intervention commencing in infancy to provide anticipatory guidance to first-time mothers on "protective" complementary feeding practices that were hypothesized to reduce childhood obesity risk. METHODS: The NOURISH RCT enrolled 698 mothers (mean age 30.1 years, SD = 5.3) with healthy term infants (51% female). Mothers were randomly allocated to usual care or to attend two 6-session, 12-week group education modules. Outcomes were assessed 5 times: baseline (infants 4.3 months); 6 months after module 1 (infants 14 months); 6 months after module 2 (infants 2 years) and at 3.5 and 5 years of age. Maternal feeding practices were self-reported using validated questionnaires. BMI Z-score was calculated from measured child height and weight. Linear mixed models evaluated intervention (group) effect across time. RESULTS: Retention at age 5 years was 61%. Across ages 2 to 5 years, intervention mothers reported less frequent use of nonresponsive feeding practices on 6 of 9 scales. At 5 years, they also reported more appropriate responses to food refusal on 7 of 12 items (Ps #.05). No statistically significant group effect was noted for anthropometric outcomes (BMI Z-score: P =.06) or the prevalence of overweight/obesity (control 13.3% vs intervention 11.4%, P =.66). CONCLUSIONS: Anticipatory guidance on complementary feeding resulted in first-time mothers reporting increased use of protective feeding practices. These intervention effects were sustained up to 5 years of age and were paralleled by a nonsignificant trend for lower child BMI Z-scores at all postintervention assessment points.

    Original languageEnglish
    Pages (from-to)e40-e49
    Number of pages10
    Issue number1
    Publication statusPublished - 1 Jul 2015

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    Daniels, L., Mallan, K., Nicholson, J., Thorpe, K., Nambiar, S., Mauch, C., & Magarey, A. (2015). An early feeding practices intervention for obesity prevention. Pediatrics, 136(1), e40-e49.