Many parents have infant-feeding, TV, and activity practices which may increase obesity risk

Eliana M. Perrin, M.D., M.P.H., is lead author of the study, associate professor of pediatrics in the University of North Carolina School of Medicine and UNC-Chapel Hill's associate vice chancellor for research. Credit: Max Englund/UNC Medical Center News Office

Most of the parents included in a new study reported some infant feeding and activity behaviors that are believed to increase a child's risk for obesity later in life.

The study found that many of these "obesogenic" behaviors were highly prevalent among all of the , regardless of their race or ethnicity. Black parents were more likely to put children to bed with a bottle and report TV watching, while Hispanic parents were more likely to encourage children to finish feeding and to report less "tummy time" – when a baby lays on her belly to play while a parent supervises.

"These results from a large population of infants—especially the high rates of television watching—teach us that we must begin even earlier, " said Eliana M. Perrin, MD, MPH, lead author of the study, associate professor of pediatrics in the University of North Carolina School of Medicine and UNC-Chapel Hill's associate vice chancellor for research. The study will be published in the April 2014 issue of the journal Pediatrics.

The study included a large, diverse sample of 863 low-income parents participating in Greenlight, an prevention trial taking place at four medical centers: UNC, New York University, Vanderbilt University and the University of Miami. Fifty percent of the parents were Hispanic, 27 percent were black and 18 percent were white. Most of the parents in the sample (86 percent) were on Medicaid.

Among all of the parents, behaviors that are thought related to later obesity were highly prevalent. Exclusive formula feeding was more than twice as common (45 percent) as exclusive breastfeeding (19 percent). Twelve percent had already introduced solid food, 43 percent put infants to bed with bottles, 23 percent propped bottles instead of holding the bottle by hand (which can result in overfeeding), 20 percent always fed when the infant cried, and 38 percent always tried to get their children to finish their milk.

In addition, 90 percent of the infants were exposed to television and 50 percent actively watched TV (meaning parents put their children in front of the television in order to watch).

"What this study taught us is that we can do better. While we don't know the exact causes of obesity, families of all races and ethnicities need early counseling to lead healthier lives. That counseling should be culturally-tailored, and we are hoping our research sheds light on the best ways to do that," said Dr. Perrin, who is a practicing pediatrician.

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