Infant Care, Feeding, and Risk of Obesity

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DESCRIPTION (provided by applicant): Overweight and obesity are increasing rapidly in the U.S., particularly among low-income minority populations. While genetic factors no doubt play an important role, environmental and behavioral factors must surely be driving the epidemic given its rapid increase in the past decade. Recent research suggests that care and feeding styles during childhood may be related to subsequent risk of obesity yet little is known about the period when infants make the transition through the weaning period to a family diet or how specific parenting styles or environments may influence the development of obesity in very young children. The obesity literature has focused primarily on children during the adiposity rebound period or older, and few studies describe risk factors in the first 2 years of life, when patterns first develop and are under parental or caregiver control. This research will examine: 1) household factors that influence parenting and infant feeding patterns; 2) relationship of feeding styles to infant diet; and 3) relationship of dietary intake to infant fatness. We will conduct the study among African American mothers and infants in North Carolina, a group at high risk for the development of obesity. In Phase I, we will conduct in-depth ethnographic research that defines culture-specific features of parenting and feeding and to identify household and contextual factors that may either prevent or promote infant obesity development in this population. This is a critical part of the research because it will allow us to define specific indicators related to our ecological model. We will also adapt an existing instrument, the Child Feeding Questionnaire (CFQ) to be culturally and age-appropriate for administration among mothers of African-Americans infants during the longitudinal study. In Phase II, we will conduct a longitudinal, observational study of 200 mother-infant African-American dyads, followed from 3-18 months of age. The study is designed to identify the constellation of household, caregiver, and child characteristics associated with the risk of obesity. Infants will be followed at 3, 6, 9, 12, and 18 months through assessments in their home environments. We will assess relationships among feeding styles, dietary intake, and infant fatness, while taking into account the role of activity, maternal BMI, and other risk factors.