Predictors of maternal feeding practices, infant growth, and obesity risk
Open Access
- Author:
- Rose, Chelsea Michele
- Graduate Program:
- Nutritional Sciences
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- September 15, 2015
- Committee Members:
- Jennifer Savage Williams, Dissertation Advisor/Co-Advisor
Leann L Birch, Dissertation Advisor/Co-Advisor
Alison Diane Gernand, Committee Member
Shannon Leanne Kelleher, Committee Member
Ian M Paul, Committee Member - Keywords:
- childhood obesity
infant feeding practices
individual differences - Abstract:
- ABSTRACT Maternal feeding practices in infancy are important for the development of children’s eating behaviors, growth, and obesity risk. Certain groups, such as first-time mothers, may be particularly vulnerable to using feeding practices that are inconsistent with current evidence-based feeding guidance. The purpose of the present research is to extend our knowledge of predictors of maternal feeding practices and their association with infant growth and obesity risk. The sample consisted of mothers participating in the Infant Feeding Practices Study II (IFPS II) and Year 6 Follow-up Study (Y6FU), a national longitudinal study of maternal feeding practices across the first year of life and at 6 years old. Data were collected approximately monthly across the first year of life and once again when the children were 6 years old. The aim of Study 1 was to describe differences between first-time and multiparous mothers in demographics, feeding practices, infant sleep, fussiness, and infant growth trajectories across the first year of life. Findings revealed that first-time mothers were more likely than multiparous mothers to report their infant was fussy and to use a number of feeding practices inconsistent with current guidance on infant feeding. Firstborns, despite being lighter at birth, surpassed later-born children at 7 months for weight-for-age z-scores. The aims of Study 2 were to use latent class analysis to identify distinct patterns of dietary exposures at 9 months, identify predictors of those patterns, and test the association between these dietary patterns and maternal and child weight outcomes at 1 year postpartum. Five classes of dietary patterns were identified: Breastfed, Fruits and Vegetables; Breastfed, Low Variety; Formula, Fruits and Vegetables; Formula, Low Variety; and Mixed, High Energy Density. The 5 dietary patterns differed in a number of maternal and child characteristics such as maternal parity, and childcare. The Mixed High Energy Density class had the highest probability of child overweight at 1 year among the latent classes. Study 3 utilized the 5 patterns of dietary exposures identified in Study 2 to test whether patterns of dietary exposures at 9 months were associated with differences in child diet and weight outcomes at 6 years. The class that most closely followed AAP infant feeding recommendations (Breastfed, Fruits and Vegetables) was most likely to meet the dietary guidelines for fruit and vegetable intake at 6 years. Infants in the Mixed, High Energy Density class had a high probability of consuming fried potatoes, and SSBs at 6 years and being overweight at 6 years. Taken together, these findings emphasize infancy as a critical period for mothers to develop nutritious and age-appropriate feeding practices to promote healthy growth and reduce obesity risk.