This research will test the effects of two interventions designed to promote healthy eating and sleeping behaviors in the first two years of life. Parents will be trained in two procedures in the home environment by visiting nurses. The procedures are designed to prevent short sleep duration and accelerated weight gain during infancy, two emerging risk factors for obesity in childhood and adulthood. Currently, between 20-25% of children aged 2 to 5 years are already overweight or at-risk for overweight making interventions that focus on infants of critical importance. Because the prevalence of overweight in young children continues to rise, primary preventive interventions are needed that 1) interrupt the natural history of obesity before it starts, 2) are easily reproducible, and 3) can be applied in the home environment where many of the behaviors that lead to obesity originate. There is evidence that prolonged breastfeeding and long sleep duration are protective factors for childhood obesity. Additionally, research has shown that the infant's neophobic response to new foods can be reduced, and new foods accepted, with repeated opportunities to try new foods. How parents deal with neophobia is crucial in determining whether the child will learn to accept a range of healthy foods, particularly foods low in energy density and high in nutrients, such as fruits and vegetables. Adequate intakes of these foods are associated with slower weight gain and lower weight status among toddlers. Participants will be randomized to receive both, one, or none of two possible interventions, delivered in the home setting by visiting nurses from a regional home health agency. First, infants will be taught to sleep through the night by 8 weeks of age using simple training procedures for parents, involving """"""""focal feedings"""""""" before bedtime, alternatives to feeding as the first alternative to infant waking and distress, and structuring the home environment to emphasize day/night differences. The second intervention, will teach parents how to help infants learn to accept new, healthy foods, using repeated exposure. To measure the impact of these interventions, change in weight-for-age z scores, night waking, and dietary intake will be assessed between birth and 2 y, and BMI will be determined at 2 y. Bioelectric impedance analysis and a laboratory evaluation for biomarkers related to obesity will be performed. An overnight polysomnographic study will also be performed at the end of the study period to assess sleep characteristics in this cohort.
| Anzman-Frasca, Stephanie; Stifter, Cynthia A; Paul, Ian M et al. (2014) Negative temperament as a moderator of intervention effects in infancy: testing a differential susceptibility model. Prev Sci 15:643-53 |
| Anzman-Frasca, Stephanie; Liu, Siwei; Gates, Kathleen M et al. (2013) Infants' Transitions out of a Fussing/Crying State Are Modifiable and Are Related to Weight Status. Infancy 18:662-686 |
| Anzman-Frasca, Stephanie; Stifter, Cynthia A; Paul, Ian M et al. (2013) Infant temperament and maternal parenting self-efficacy predict child weight outcomes. Infant Behav Dev 36:494-7 |
| Birch, Leann L; Anzman-Frasca, Stephanie (2011) Promoting children's healthy eating in obesogenic environments: Lessons learned from the rat. Physiol Behav 104:641-5 |
| Paul, Ian M; Savage, Jennifer S; Anzman, Stephanie L et al. (2011) Preventing obesity during infancy: a pilot study. Obesity (Silver Spring) 19:353-61 |
| Laraway, Kelly A; Birch, Leann L; Shaffer, Michele L et al. (2010) Parent perception of healthy infant and toddler growth. Clin Pediatr (Phila) 49:343-9 |
| Paul, Ian M; Bartok, Cynthia J; Downs, Danielle S et al. (2009) Opportunities for the primary prevention of obesity during infancy. Adv Pediatr 56:107-33 |
