Low-Income Moms Under Stress May Overfeed Infants

Efforts to prevent obesity among low-income infants should focus not only on what babies are being fed but also the reasons behind unhealthy feeding practices, according to a study to be presented at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Adding cereal to bottles is one unhealthy practice that is discouraged by the American Academy of Pediatrics because it may lead to overfeeding and excess weight gain in infants.

Researchers sought to determine factors associated with putting cereal in bottles among low-income, primarily Latino households in which the risk for child obesity is high.

Mothers of 254 infants were asked if they ever added cereal to bottles to help their babies sleep longer or stay full longer. Researchers also collected information on mothers’ age, language, country of origin, marital status, education and income; whether the mother had symptoms of depression; and infants’ age, gender and whether the infant was felt to have strong emotional reactions (a high intensity temperament).

The data were collected as part of the larger Bellevue Project for Early Language, Literacy and Education Success (BELLE Project). Funded by the National Institutes of Health/National Institute of Child Health and Human Development, the BELLE Project is following infants from birth to first grade to study issues related to parenting and child development.

Results showed that 24 percent of mothers put cereal in bottles. Those with depressive symptoms were 15 times more likely to add cereal than mothers who did not have symptoms of depression.

Depression is very common in low-income mothers and makes it more difficult to engage in beneficial parenting practices in general,” said lead author and general academic pediatrics fellow Candice Taylor Lucas, MD, MPH, who also is the Alan Mendelsohn, MD, principal investigator and associate professor of pediatrics, New York University School of Medicine and Bellevue Hospital Center. “Our results are especially concerning because they suggest that depressed mothers may be more likely to add cereal to the bottle, which may increase their children’s risk of obesity.”

Data also showed that mothers who were single were significantly more likely to add cereal to bottles. “This suggests that mothers’ support systems and family dynamics may influence feeding practices,” said obesity researcher and fellow investigator Mary Jo Messito, MD, FAAP.

Mothers who felt that their children had intense emotional reactions to daily routines were 12 times more likely to add cereal to bottles.

“Overall, these findings demonstrate that stressors prevalent in low-income households, such as depression, single parenthood and associated infant behavioral challenges, influence feeding practices likely to promote obesity,” Dr. Lucas concluded. “It is important to provide support for parents related to healthy feeding practices if we are to end the epidemic of childhood obesity.”

Source: This information is reproduced with editorial adaptations from a press release issued by the American Academy of Pediatrics. For more information click here. The study was funded by the Institute of Education Sciences at the U.S. Department of Education.

Reviewed by:Rajeev Kurapati MD

Nurturing Mothers Lead to Physically Healthier Adults

Reviewed by: Rajeev Kurapati MD

Nurturing mothers have garnered accolades for rescuing skinned knees on the playground and coaxing their children to sleep with lullabies. Now they’re gaining merit for their offspring’s physical health in middle age.

Brandeis psychologist Margie Lachman with Gregory Miller and colleagues at the University of British Columbia and the University of California, Los Angeles reveal that while children raised in families with low socioeconomic status (SES) frequently go on to have high rates of chronic illness in adulthood, a sizable minority remain healthy across the life course. The research sought to examine if parental nurturance could decrease the effects of childhood disadvantage.

The team is working to understand the sources of social disparities in health and what can be done to reduce them. Funded by the National Institute on Aging as part of the Midlife in the United States (MIDUS) study, this information will then be used to empower families through education.

People who are low in socioeconomic status have worse health than their same age counterparts, a phenomenon called the social gradient in health. Modifiable factors play an important role, and we are realizing that things can be done to try to minimize these health disparities.

Clearly money and health care access are part of it, , but numerous studies show they play a very small role, as countries with universal health care have the same social gradient.

While they have looked at income in other studies, the team has found that the level of educational attainment is a more reliable indicator of socioeconomic status; people who have a college education do well in many areas, such as physical health, psychological well-being and cognitive function. Her team is looking for ways to reduce the differences, as not all lower-socioeconomic status people fare the same — some, Lachman says, are physically and cognitively active and have good social support, resources which seems to reduce their risks for poorer functioning.

Emerging literature reveals that many of the health problems in midlife, including metabolic syndrome, can be traced back to what happened in early childhood. The stresses of childhood can leave a biological residue that shows up in midlife, explains Lachman. Yet, among those at risk for poor health, adults who had nurturing mothers in childhood fared better in physical health in midlife.

“Perhaps it’s a combination of empathy, the teaching of coping strategies or support for enrichment,” says Lachman. “We want to understand what it is about having a nurturing mother that allows you to escape the vulnerabilities of being in a low socioeconomic status background and wind up healthier than your counterparts.”

The study has followed the same 1,205 people for over a decade. Nurturance was assessed with data and included questions such as: How much did she understand your problems and worries and how much time and attention did she give you when you needed it?

“We would like to try to use this information to bolster vulnerable families who are at risk for not doing well,” says Lachman. “Teaching them parenting skills to show children concern for their welfare, how to cope with stress, that they have some control over their destinies, and how to engage in health-promoting behaviors such as good diet and exercise — the things that could protect against metabolic syndrome.”

There still may be steps that can be taken later in life to reduce risk for those who are vulnerable, Lachman says.

Interestingly, in this study, paternal nurturing did not contribute to resilience.

“It could be that the results are tied to the particular cohort studied, and there may be generational differences,” says Lachman. “With this cohort, people who are now in midlife, fathers weren’t typically very involved. Paternal nurturance may play more of a role for the children of these midlife fathers who, in contrast, are more involved in the lives of their children and perhaps more nurturant.”

As the study continues they will be able to look at new generations of middle-aged adults who have had different parenting experiences.

Source: This information is reproduced with editorial adaptations from a press release issued by the Brandeis University. For more information click here.