Study finds link between ‘responsive parenting’ and lower childhood obesity

Children of first-time moms schooled in “responsive parenting” were less likely to battle obesity by age 3 than those whose moms didn’t receive such assistance — a revelation that comes as no shock to health care providers in the area.

New research funded through the National Institutes of Health showed an intervention designed to teach rookie mothers to respond to babies’ cues for hunger, sleep and other crucial infant needs “significantly improved the body mass index of the child through age 3 years compared with the control group.”

That makes sense to Dr. Gerald Rakos, chairman of pediatrics at Stamford Hospital.

“I think it’s definitely plausible” that teaching parents to properly respond to their children’s cues could reduce obesity, he said. “I think any parent has been in a situation where the child is crying and fussy, and it’s kind of easy to just feed them to quiet them down. But, as you gain experience as a parent, you learn that not all crying is bad, and the cause is not always hunger.”

Responding to needs

The NIH study, published in the Journal of the American Medical Society, randomly assigned first-time mothers and their infants into two groups to determine if an intervention in “responsive parenting” delivered during infancy and early childhood promoted healthy weight gain leading to improved body mass index scores. Body mass index is a measure of body fat, based on height and weight. It’s the standard most often used to determine whether someone is “normal” weight, overweight or obese.

The 279 mothers who participated were an average of 28 years old, mostly white, married, well-educated, and privately insured.

First-time mothers assigned to the “responsive parenting” group were educated on how to respond to four main categories of infant needs — feeding, sleep, interactive play, and emotional regulation. These mothers were also taught such strategies as how to put infants to bed drowsy, but awake, and avoid feeding infants to sleep. They were also instructed about when to introduce solid foods, how to use growth charts and how to limit sedentary time.

At age 3 years, in the responsive parenting group, 11.2 percent of children were overweight, compared to 19.8 percent in the control group. Further, only 2.6 percent of children in the responsive group were considered obese, whereas, 7.8 percent were considered obese in the control group.

Obesity risks

Obesity is an ongoing public health crisis, and according to the NIH, it affects 13.9 percent of children ages 2 to 5 years. In Connecticut, as of 2016, roughly 15.6 percent of children aged 2 to 4 years in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program were overweight and 16.6 percent of them were obese, according to the Centers for Disease Control and Prevention.

Children who have obesity are at increased risk for developing Type 2 diabetes, heart disease, high blood pressure, asthma and other serious health problems in early childhood and later in life.

In Connecticut, there are some organizations and care providers that offer parents education on caring for infants. For instance, Griffin Hospital in Derby offers a prenatal class in breastfeeding for beginners, in which parents are taught about feeding cues.

Perinatal nurse educator Michelle Pompano said that before the discharge of every mother and baby, “our nurses review teaching checklists that include topics directly related to responding to their infants. Discussion topics such as swaddling, safe sleep, burping and positioning are included in the extensive teaching.”

Patients also return two to three days after discharge for a postpartum return visit, at which a nurse performs assessments on mother and baby, offers additional education and gives the family the opportunity to ask questions about caring for their baby.

Rakos, meanwhile, said after families are discharged from Stamford, there isn’t typically much follow-up, though some parents are referred to outside programs, such as St. Joseph’s Parenting Center in Stamford. He said the NIH research is intriguing, though he added that it’s likely that better educating parents about on how to respond to infants’ cues is only one of many factors contributing to a child’s weight.

However, Rakos said, given how common and potentially damaging childhood obesity is, this kind of research is necessary. He said there has been a lot of progress over the years in addressing a variety of public health crises, including HIV, smoking and heart disease.

But, Rakos said, obesity continues to be a challenge.

“We’re not making much of a dent,” he said.

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