Grow well/Crecer bien: a protocol for research on infant feeding practices in low-income families
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STUDY PROTOCOL
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Grow well/Crecer bien: a protocol for research on infant feeding practices in lowincome families Ann M. Cheney1* , Tanya Nieri2, Ana Ramirez Zarate3, Gretel Garcia4, Lucero Vaca1, Esmirna Valencia5, Colleen Versteeg6, Arlene Molina7, Michael Castillo8 and Alison Tovar9
Abstract Background: The prevalence of obesity among children remains high. Given obesity’s significant lifelong consequences, there is great interest in preventing obesity early in life. There is a need to better understand the relation of common infant feeding styles and practices to obesity in infants using longitudinal study designs. There is also an urgent need to understand the role of caregivers other than mothers in feeding. A better understanding of variation in feeding styles and practices can inform the identification of risk groups and the tailoring of interventions to them. Methods: In partnership with Early Head Start programs across four counties in southern California, mothers and infants will be enrolled in a two-year longitudinal study collecting survey and anthropometric data. A subsample of mothers and their selected other caregivers will participate in qualitative research involving feeding diaries and dyadic interviews. The results will be used to develop and test an enhanced nutrition education program. Discussion: We outline a study methodology to examine feeding styles and practices and their association with early childhood obesity risk and enhance an existing intervention to promote healthy infant feeding and growth among children in low-income families. Keywords: Obesity, Infant feeding practices, Infant feeding styles, Low-income families, Nutrition education
Background Obesity prevalence among infants, toddlers, and preschool children in the United States (US) has doubled from the 1970s to the twenty-first century [1, 2]. Although rates have generally stabilized among some populations, racial/ethnic and socioeconomic disparities persist [3, 4]. For example, 9.4% of Latinx infants have a weight-for-length > 95th percentile relative to 6.6% of non-Latinx white infants. Although there has been a growing literature to better understand risk factors for * Correspondence: [email protected] 1 Department of Social Medicine Population and Public Health, 900 University Ave, Riverside 92501, USA Full list of author information is available at the end of the article
obesity early in life, it remains unclear how feeding impacts early life risk for obesity among racial/ethnic minority children [5–9]. The American Academy of Pediatrics recommends exclusive breastfeeding as the optimal form of infant nutrition for the first 6 months and continued supplemental breastfeeding for 1 year. At 6 months, they recommend the introduction of a wide variety of nutrient-dense complementary foods. Starting at 9 months, they recommend three nutrient-dense meals and two or three small nutrient-dense snacks per day. Despite these guidelines racial/ethnic minority infants consume too many energy-dense foods and in
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