Objective: This project aimed to prevent obesity in high-risk infants using community health workers.ßto provide mothers with culturally appropriate nutrition and health education.
Methods: This randomized controlled trial enrolled mothers prenatally and infants at birth. Mothers were Spanish-speaking WIC participants with obesity. Trained, Spanish-fluent, community health workers visited homes of intervention mothers to encourage breastfeeding, and promote delayed introduction of solid foods, adequate sleep, limited screen time, and active play. A blinded research assistant collected data at the home. Outcomes were weight-for-length and BMI-z scores, obesity at age 3.ßyears and percent time obese during follow-up. Data were analyzed using multiple variable regression.
Results: Of 177 children enrolled at birth, 108 were followed to age 30...36.ßmonths. At the final visit, 24% of children were obese. Obese status at age 3.ßdid not differ between intervention and control (P.ß=.ß.32). Using BMI-z at the final visit, we observed a significant interaction between education and breastfeeding (P.ß=.ß.01). Time spent while obese from birth until age 30...36.ßmonths, by multiple variable analysis, did not show significant differences between intervention and control, but breastfed children experienced significantly less time obese than formula fed (P.ß=.ß.03). Formula-fed children in the control group, spent 29.8% of time obese, while breastfed infants in the intervention group spent 11.9% of time obese.
Conclusions: The educational intervention did not prevent obesity at age 3.ßyears. However, time spent obese from birth to age 3.ßyears was best in breastfed children living in homes regularly visited by community health workers.
Keywords: child; education; nutrition; obesity; prevention.
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