Non-maternal Involvement in Feeding and the Development of Obesogenic Diets among Infants and Toddlers

Wasser, Heather

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March 22, 2019

Creator

Wasser, Heather
- Affiliation: Gillings School of Global Public Health, Department of Nutrition

Abstract

The prevalence of overweight among infants and toddlers has increased by approximately 35% over the last 30 years. Concurrent to this rise, there was an increase in maternal employment and the use of non-maternal caregivers while the mother is working. Despite these important social changes, few studies have examined non-maternal involvement in feeding between birth and two years. Specific aims of the current research were: (1) to quantify longitudinal intakes of obesity-related foods and beverages during the period of complementary feeding; (2) to characterize the extent to which non-maternal caregivers share responsibility for feeding during the first two years of life; and, (3) to determine associations between non-maternal involvement in feeding and dietary intakes of infants and toddlers. To achieve these aims, we used data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 low-income, African-American mother-infant dyads, followed from 3-18 months postpartum. Our results showed that the proportion of infants and toddlers consuming any amount of selected foods and beverages increased over time. Total daily servings of low energy-dense foods (e.g. fruits and vegetables) remained constant over time while high energy-dense foods and beverages (e.g. desserts and sweets, fried potatoes) increased by 125% to 800% between six and 18 months, with the greatest increases occurring between nine and 12 months of age. Non-maternal involvement in feeding was highly prevalent, with more than half of all households at each time point reporting the use of a non-maternal caregiver (NMC)--someone other than the mother responsible for feeding the infant ≥50% of his/her daily meals. Common NMCs were fathers, grandmothers, and licensed childcare providers. In longitudinal models, we found use of any NMC to be associated with decreased odds of breastfeeding and increased odds of infants and toddlers consuming fruit or juice. Thus, potentially obesogenic diets begin early, suggesting anticipatory guidance on healthy feeding practices is needed prenatally and/or in the first few months postpartum, and the inclusion of NMCs in future observational and experimental studies is warranted as they are highly involved in the feeding of infants and toddlers and impact dietary intake.

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