Young children living in historically marginalized families are at risk for becoming adolescents with obesity and subsequently adults with increased obesity-related morbidities. These risks are particularly acute for Hispanic children. We hypothesized that the prevention-focused, socioecological approach of the “Minding the Baby” (MTB) home visiting program might decrease the rate of childhood overweight and obesity early in life.
This study is a prospective longitudinal cohort study in which we include data collected during 2 phases of the MTB randomized controlled trial. First-time, young mothers who lived in medically underserved communities were invited to participate in the MTB program. Data were collected on demographics, maternal mental health, and anthropometrics of 158 children from birth to 2 years.
More children in the intervention group had a healthy BMI at 2 years. The rate of obesity was significantly higher (P < .01) in the control group (19.7%) compared with the intervention group (3.3%) at this age. Among Hispanic families, children in the MTB intervention were less likely to have overweight or obesity (odds ratio = 0.32; 95% confidence interval: 0.13–0.78).
Using the MTB program, we significantly lowered the rate of obesity among 2-year-old children living in low-socioeconomic-status communities. In addition, children of Hispanic mothers were less likely to have overweight or obesity at 2 years. Given the high and disproportionate national prevalence of Hispanic young children with overweight and obesity and the increased costs of obesity-related morbidities, these findings have important clinical, research, and policy implications.
Comments
A Home Visiting Parenting Program
I found the article “A Home Visiting Parenting Program and Child Obesity: A Randomized Trial” by Ordway et al. (January 2018) quite intriguing as a future social worker. Although there are many therapeutic interventions to decrease rates of childhood obesity, with the rise of such childhood obesity, it is important to recognize the importance of a therapeutic connection between the mother and child. A 2018 study by Byrne et al. found that this increased bond between mothers and their breastfed children may contribute to lower obesity rates as the children mature into adolescence.1 Byrne et al. also determined that, “higher socioeconomic status was associated with a longer duration of breastfeeding, which in turn is associated with a lower BMI score in adolescence.” 1
Ordway et al. report that young children are susceptible to obesity among Hispanic families and such may persist into adolescence. The researchers created a home visiting program that would help decrease the obesity rates among Hispanic families titled: Minding the Baby (MTB). This study collected data from two groups: control (women receiving prenatal and primary care) and intervention (women receiving standard care along with MTB program). The results concluded that the MTB intervention is an effective way in reducing obesity rates. In addition, the MTB program also focused on developing a foundation for healthy development between mother and child. In particular, social workers and pediatric nurses educated mothers throughout their third trimester of pregnancy with regards to the benefits of breast feeding such as: decreased obesity, increased parental attachment, and increased cognition.2
A 2012 study by McCrory & Layte determined that “being breastfed between 13 and 25 weeks was associated with a 38 percent (p < 0.05) reduction in the risk of obesity at nine-years of age, while being breastfed for 26 weeks or more was associated with a 51 percent (p < 0.01) reduction in the risk of obesity at nine-years of age.”3 This study proved that there is a lower chance of children that were breastfed for more than a month to be obese or overweight throughout their childhood.
Additional research is needed to identify the programs that can provide positive parenting behaviors for bonding with their child; such studies should include further examination regarding the long-term positive effects of breastfeeding and how such contributes to further solidifying the bond between mother and child as well as lowering obesity rates in our children.
Ericka Melendez
Health Studies
Utica College
Utica, NY
References:
1. Byrne ML, Schwartz OS, Simmons JG, Sheeber L, Whittle S, Allen,NB. Duration of breastfeeding and subsequent adolescent obesity: Effects of maternal behavior and socioeconomic status. J Adolesc Health. 2018; 62(4): 471-479
2. Ordway MR, Sadler LS, Holland ML, Slade A, Close N, Mayes LC. A home visiting parenting program and child obesity: A randomized trial. Pediatrics. 2018; 141(2): e20171076
3. McCrory C, Layte R. Breastfeeding and risk of overweight and obesity at nine-years of age. Soc Sci Med. 2012;75(2): 323-330
RE: A Home Visiting Parenting Program and Child Obesity: A Randomized Trial
This topic is interesting because obesity is something that is very prevalent in our world today. I have a large space in my heart for children, resulting in my choice of career which will eventually involve working in the health care field with children. From being in the grocery store to the mall there are more children that one notices that can be considered overweight. This topic is something that needs to be advocated for before it affects to many generations resulting in an increase in health problems for individuals at a young age and decrease in longevity.
This article relates to health care today because many children are obese and this condition is affecting more children than in the past. As stated by the American Heart Association, obesity is the top major health concern to parents in the United States (American heart association, 2014). Obesity is seen as an eating problem but as described in the research article “A Home Visiting Parenting Program and Child Obesity: A Randomized Trial,” obesity is not all about a child’s eating habits it also is largely affected by the child’s family (Ordway et. al., 2017).
Obesity causes many affects to a child’s health such as high blood pressure, high cholesterol, and possibility of diabetes (American heart association, 2014). It’s not only the things that affect the child’s physical health, obesity also affects the child’s self-esteem, body image, and these affects can cause mental health problems such as depression (American heart association, 2014). These affects that obesity has on children and adolescents are thought to be ways that this topic relates to Evidence Based Practice. As an experienced clinician, when speaking to a child and their family about topics such as obesity, patient values need to be accounted for. Evidence Based Practice is considered to be the decision making process for patient care. So, for a physician to make a decision regarding a child diagnosed with obesity, many different factors need to be examined.
An article titled “Obesity Begins Early” by the National Institutes of Health states that children who are overweight by the age of five years old are more likely to become obese teenagers or even adults (NIH, 2014). This article’s information is closely related to the article, “A Home Visiting Parenting Program and Child Obesity: A Randomized Trial.” Within this article it states that Centers for Disease Control and Prevention [CDC], reports data stating that twelve percent of preschoolers are obese (NIH, 2014). “Obesity Begins Early” also supports the article about home visiting programs by stating that there is an encouragement for families to eat meals together (parents eat with their children) (NIH, 2014). This supports the idea that obesity can be prevented and it is not truly a hundred percent correlated with eating habits, it also has to do with family relationships. Also mentioned in the article “Obesity Begins Early”, there are programs out there for children such as, “Media Smart Youth,” which correlates the medias influence on a child’s health, nutrition, and physical activity (NIH, 2014). This directly relates to our society today. Things like this program mentioned allows children to use media to benefit their lifestyle.
As regards to future health care practice, it is very important to advocate for a healthy lifestyle as early as possible. As health care providers, provide for their patients when the patient is very young, it is important to inform their care takers the possibility of their child becoming obese. It is extremely important to mention to the patient’s guardian’s that obesity can be prevalent by the age of two years old. Even though the article “A Home Visiting Parenting Program and Child Obesity: A Randomized Trial” stated that their experimental procedures supported their hypothesis, concluding that the interventions help reduce the risk of obesity. The authors forgot to mention the importance of education. The earlier the individual and their guardian’s know about their likelihood of obesity the easier it is for the individual and their guardians’ to decrease the risk. For future health care practice it is important to be aware of the possible reactions that can come with the diagnosis of obesity. An increase of importance on this topic is directly relating to the increasing prevalence of childhood obesity. Without increased education on this topic the more children will become obese and the population of these children will have many health related issues along with decrease longevity.
References
American heart association. (August, 2014). Overweight in children. Retrieved from http://www.heart.org/HEARTORG/HealthyLiving/HealthyKids/ChildhoodObesity...
National institutes of health [NIH]. (February 26, 2014). Obesity begins early. Retrieved from https://www.nichd.nih.gov/about/overview/directors_corner/prev_updates/0...
Ordway, M. R., Sadler, L. S., Holland, M. L., Slade, A., Close, N., Mayes, L. C. (November 1, 2017). A home visiting parenting program and child obesity: A randomized trial. Retrieved from http://pediatrics.aappublications.org/content/pediatrics/141/2/e20171076...