BODY SIZE AS A DETERMINANT OF INFANT ADIPOSITY: DISCUSSION

17 Dec
2009

infant adiposity

Several important findings were observed in this study. It was determined that 57% of infants perceived to be small at birth received nonmilk foods before two months, compared to 50% of average and large infants, respectively (Table 5). There was no significant difference in means observed between large and small infants, but between average and small infants a significant difference in solid food introduction was observed (p=0.03). Though there was no significant difference found between large and small infants, percentage-wise, more large infants received nonmilk foods before four months, compared to those perceived to be average.

The high degree of early introduction of nonmilk foods observed in this sample of mothers support the reports of Bronner et al. (1999), Bentley et al. (1999), Baughcum et al. (1998), and Underwood et al. (1997), where a high percentage of the infants in their studies were observed to receive nonmilk foods early. Additionally, the findings also supports that of Crow and colleagues, where it was observed that maternal nurturing behaviors, such as feeding and pushing the nipple in a baby’s mouth, were more prevalent among women with low birth-weight babies. The negative correlation found between infant BMI (Quetelet index) and nonmilk foods introduction, as presented in Table 6, indicated that the earlier the introduction of nonmilk foods the larger the infants BMI by the end of the study. The finding fits the observations of other researchers regarding feeding and infant weight. It was noted, however, that there was no correlation between the time of cereal introduction and infant BMI. Perhaps the reason cereals did not feature prominently is because the majority of babies received cereal early and, thus, the effect of cereal on adiposity could not be detected. Secondly, it was also noted in this study that the primary reason mothers gave cereal was not for growth but rather for sleep and convenience—so they did not aim to make their infants large per se but to keep them satisfied. Baughcum and colleagues also observed this in their study in which some of their participants introduced cereal to help their babies sleep through the night. It also supports the findings of Bentley et а in which it was observed that grandmothers played a significant role in deciding and offering nonmilk foods to infants. silagra tablets

Concerning infant feeding beliefs and practices, a significant finding was that infant satiety was determined by the length of time an infant slept. Consequently, feeding efforts which increased infants’ sleep time, such as cereal feeding, were prevalent and viewed as positive by most mothers. The use of food for comfort and satiety was also observed to predispose infants to force-feeding, which is currently being debated in the literature as a possible factor in the development of childhood obesity. Forty-nine percent of the women were assessed as displaying the potential for force-feeding based on the responses given in the MIFPQ. It is intuitive that a counterargument here could be that perhaps mothers were trying to prevent waste and save money when encouraging their infants to finish the bottle. We submit that the subjects were WIC participants and, therefore, did not have to worry about the cost of infant formula. It seems something other than economics may be operating in the observation noted here and needs to be examined further.

One of the goals of this study was to examine how maternal weight affected body size perceptions. It was detected that overweight/obese women did underestimate their infants’ sizes when compared with women of normal BMI, as evidenced by the fact that among the 17 infants who were above the 95th percentile for weight-for-height measures, those with overweight mothers were twice as likely to be classified as slim (#1) or average (#3) on the AAIBH scale, when their actual BMI placed them in the overweight category. Similarly, using the questionnaires, we found that about one-fifth of the mothers measured infant healthiness by fatness, supporting previously reported observations by Baughcum and colleagues. canadian cialis online

Finally, according to the Satisfaction Index in Table 2, over 52% of the infants did not attain their maternal preferred size. Most significant here was that one-fifth of these infants were perceived as larger than their maternal preferred size. This finding suggests that if maternal preference was one of the most important determinants of an infant’s adiposity status, as suggested by Alexander and Kramer, and secondly, if it is assumed that parents consciously promote feeding actions that allow their children to attain their preferred size, then the majority of infants should have been observed to have attained their maternal preferred size. However, this was not what was observed in this study. The lack of significant correlation between maternal preference for infant size and actual infant size raises the question of whether Alexander and Kramer’s findings are applicable to inner-city African-American mothers of newborns. Indeed, the data highlighted several other factors that may be responsible for the infants’ weight outcomes. For example, the impact of the feeding and size preference of other significant child caregivers, such as grandparents, fathers, and other relatives, may be a contributing factor. It is intuitively understood that, regardless of the mother’s size preference for her child, if other caregivers are responsible for feeding the infant for a significant period of time in the first six months, the child’s weight outcome would be more strongly influenced by the caregivers’ beliefs and corresponding feeding actions rather than the mothers’ preference. This scenario would be especially true in this population in which mothers are more likely to leave their infants with their older female relatives who significantly influence feeding decisions, according to findings by Bentley et al. Additionally, new mothers’ need for a good night’s sleep may also be a contributing factor. Women in the inner city, especially single mothers, who constituted 84% of this study population, face multiple demands on their daytime hours with little or no time for naps. Therefore, a baby who sleeps through the night can be an asset in making their lives manageable. Indeed, the findings of the food frequency questionnaire showed that many of the mothers believed that the introduction of cereal was useful in promoting infant satiety and sleep-time. Therefore, we suggest that for this study, intervening variables, such as the mother’s need for adequate rest and the impact of other caregivers’ beliefs and practices on the outcome of the infants weight status, need to be examined further before a definitive statement of refusal or support can be made of the findings by Alexander and Kramer.

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