August 28, 2018

Responsive parenting affects childhood weight

At a Glance

  • Teaching first-time mothers how to respond to their infant’s body cues reduced the children’s weight by age 3 compared with a control group.
  • This study suggests a public health intervention strategy that may help reduce excess childhood weight.
Young mother with baby boy carrying groceries to car Parents play an important role in establishing healthy eating habits.Halfpoint/iStock/Thinkstock

More than 25% of children between the ages of 2 to 5 are considered overweight or obese. Children with excess weight are at increased risk for developing type 2 diabetes, heart disease, high blood pressure, asthma and other serious health problems later in life.   

The Intervention Nurses Start Infants Growing on Health Trajectories (INSIGHT) study was set up in 2012 to investigate whether teaching “responsive parenting” techniques to first time mothers during their child’s infancy could help prevent rapid weight gain in infancy and establish healthier growth patterns during childhood.

Responsive parenting encourages parents to respond to their children promptly in a way that is appropriate for their age and meets the child’s needs. For example, parents are taught how to recognize signs that their infant is full to know when to stop feeding. Previous reports from the study showed that responsive parenting reduced rapid weight gain over the first six months of life, reduced children’s body mass index (BMI)—a measure of body fat based on height and weight—at 1 year old, and improved infants’ sleeping patterns.

A team led by Drs. Leann L. Birch at the University of Georgia and Dr. Ian M. Paul at Pennsylvania State University reported study results after three years in the Journal of the American Medical Association on August 7, 2018. The research was supported by NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Of the 279 mothers and their infants who were enrolled, 232 completed the three-year trial. The mothers were 28 years old on average, mostly white, married, and had a college-level education or higher. They were randomly assigned to one of two groups. The responsive parenting group was taught about responding to their infant’s feeding, sleep, play, and emotional needs. The control group was taught about home safety. Both groups received four home visits from a research nurse during infancy, followed by annual research center visits at 1, 2, and 3 years old.

After three years, children in the responsive parenting group had a significantly lower average BMI than those in the control group. In addition, 13 children (11.2%) were overweight and 3 (2.6%) were obese in the responsive parenting group compared with 23 (19.8%) overweight and 9 (7.8%) obese in the control group. However, these differences in overweight and obesity weren’t large enough at age 3 to show they weren’t due to chance.      

“Infancy is a critical period for parents and health care providers to intervene and promote healthy behaviors, and INSIGHT results show us a way to do this effectively,” says NIDDK Director Dr. Griffin P. Rodgers. “These important findings help us better understand the important role that infancy and early childhood play in developing healthy habits and preventing obesity.”

“Although INSIGHT participants were primarily white and of higher socioeconomic status,” Paul says, “we believe components of the intervention can be successfully implemented in more diverse and lower income populations, and this is currently being studied.”

Related Links

References: Effect of a Responsive Parenting Educational Intervention on Childhood Weight Outcomes at 3 Years of Age: The INSIGHT Randomized Clinical Trial. Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Beiler JS, Hess LB, Loken E, Birch LL. JAMA. 2018 Aug 7;320(5):461-468. doi: 10.1001/jama.2018.9432. PMID: 30088009.

Funding: NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and National Center for Advancing Translational Sciences (NCATS); Children’s Miracle Network at Penn State Children’s Hospital; US Department of Agriculture; and the Pennsylvania State University Clinical and Translational Research Institute.