A Pilot-Feasibility Study of a Home-based Intervention to Reduce Obesity Risk for Bottle-fed Infants

降低奶瓶喂养婴儿肥胖风险的家庭干预试点可行性研究

• 批准号: 9762663
• 负责人: Alison K. Ventura
• 金额: $ 20.78万
• 依托单位: CALIFORNIA POLY STATE U SAN LUIS OBISPO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-12 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9762663
• 关键词: Adherence; Adopted; Age-Months; Bottle feeding; Breast Feeding; Breastfed infant; Caregivers; Characteristics; Child; Code; Communities; Consumption; Cues; Data; Development; Discipline of Nursing; Enrollment; Ethnic Origin; Excision; Exclusive Breastfeeding; Exhibits; Family; Feasibility Studies; Feeding Patterns; Feeding behaviors; Funding; Government; Growth; Hispanics; Home environment; Human Milk; Infant; Intake; Intervention; Laboratories; Laboratory Finding; Learning; Left; Length; Life; Measures; Milk; Minority; Mothers; Obesity; Outcome; Overweight; Parent-Child Relations; Perception; Prevention approach; Procedures; Public Health; Race; Randomized; Records; Regulation; Reporting; Research; Research Personnel; Risk; Risk Factors; Safety; Sampling; Satiation; Socioeconomic Status; Temperament; Testing; Trust; United States National Institutes of Health; Weight; Weight Gain; base; demographics; experience; feeding; high risk; improved; improved outcome; infancy; intervention effect; low socioeconomic status; novel; obesity in children; obesity prevention; obesity risk; parity; peer; postnatal; programs; randomized trial; response; sex; success; tool; waist circumference

ABSTRACT One of the earliest postnatal risk factors for obesity is rapid weight gain during early infancy and formula-fed infants are at greater risk for excessive weight gain than breastfed infants. There are many benefits of exclusive breastfeeding, making promotion of breastfeeding the ideal. However, significant proportions of mothers formula-feed, either exclusively or in combination with breastfeeding, and these mothers report a lack of support for learning and adopting healthy bottle-feeding practices. A growing body of evidence suggests that formula-feeding mothers may develop more controlling feeding practices due to their ability to feed in response to amount of formula in the bottle, instead of in response to infant satiety cues, leading to overfeeding, rapid weight gain, and risk for obesity. The overall objective of the proposed pilot/feasibility study is to evaluate a home- and family-based intervention to increase formula-feeding mothers’ responsiveness to infant satiety cues and moderate formula-feeding infants’ rates of weight gain over a 12-week period. Specifically, we propose to provide mothers with opaque, weighted bottles (instead of conventional, clear bottles) with which to feed their infants; based on our preliminary studies, we hypothesize that removal of mothers’ abilities to assess the amount the infant consumes during a feeding will facilitate abilities to feed in response to infant satiation cues.For the proposed research, exclusively formula-feeding mothers with <2-week-old infants will be randomized to use weighted, opaque bottles (intervention or opaque group) or to use their preferred, clear bottles (control or clear group). We will conduct home-based assessments at the beginning and end of the 12- week study period, during which we will video-record mothers feeding their infants using clear or opaque bottles. We will also conduct two interim home assessments (after 2 and 6 weeks) to assess feeding adequacy and fidelity to the intervention. During feeding observations, infant intake will be assessed via bottle weight. Video-records will be later coded for maternal responsiveness to infant cues using the Nursing Child Assessment Parent-Child Interaction Feeding Scale (NCAFS). We hypothesize that mothers in the opaque group will feed their infants less and show greater increases in their levels of responsiveness to infant cues compared to mothers in the clear group. Infants’ weight and length will be measured at the beginning and end of the 12-week study; weight-for-length z-scores (WLZ) will be calculated using the WHO Growth Standards. We hypothesize that WLZ change will be significantly lower for infants in the opaque compared to the clear group. We will also explore the feasibility of our intervention by collecting and analyzing objective and subjective data related to the extent to which mothers use and like the bottles, and whether characteristics of mothers or infants moderate intervention effects. The proposed feasibility study is a critical step toward understanding mothers’ acceptance and use of opaque bottles compared to conventional, clear bottles, and the potential for opaque bottles to improve the outcome of feeding interactions in home-based settings.

抽象的 肥胖后最早的产后危险因素之一是婴儿早期和配方奶 婴儿比母乳喂养的婴儿面临更大的体重增加的风险。有很多好处 独家母乳喂养，使母乳喂养成为理想。但是，很大的比例 母亲配方奶粉，无论是专门的还是与母乳喂养结合的，这些母亲报告说缺乏 支持学习和采用健康的奶瓶喂养实践。越来越多的证据表明 配方奶粉母亲可能会因喂养能力而发展更多控制喂养实践 瓶中的配方奶量，而不是响应婴儿饱腹感，导致过度喂养，快速 体重增加和对象的风险。拟议的飞行员/可行性研究的总体目的是评估 基于家庭和家庭的干预措施，以增加喂养母亲对婴儿饱腹感的反应 提示和中等配方奶粉在12周期间的体重增加率。具体来说，我们 为母亲提供不透明的加权瓶（而不是传统的透明瓶）的建议 喂养婴儿；基于我们的初步研究，我们假设删除母亲评估的能力 婴儿在喂养期间消耗的数量将有助于响应婴儿满意度的能力 提示。对于拟议的研究，专门为患有<2周大婴儿的公式喂养母亲 随机使用加权，不透明的瓶（干预或不透明组）或使用其首选，清除 瓶子（控制或清除组）。我们将在12-的开始和结束时进行基于家庭的评估 一周的学习期，在此期间，我们将使用清晰或不透明的视频记录母亲为婴儿喂养婴儿 瓶子。我们还将进行两次临时房屋评估（2周和6周后）以评估喂养功能 和对干预的忠诚。在进食观察期间，将通过瓶重量评估婴儿摄入量。 视频记录将随后使用哺乳孩子编码以确定对婴儿提示的孕产妇响应能力 评估亲子互动量表（NCAF）。我们假设那个不透明的母亲 小组将减少其婴儿的养活，并显示出对婴儿提示的反应水平的提高 与明确群体中的母亲相比。婴儿的体重和长度将在开始和结束时测量 这项为期12周的研究；重量长度Z分数（WLZ）将使用WHO生长标准计算。 我们假设不透明的婴儿与清晰 团体。我们还将通过收集和分析目标以及 主观数据与母亲使用和喜欢瓶子的程度有关，以及是否特征 母亲或婴儿中度干预效果。拟议的可行性研究是迈向的关键一步 与传统，清晰的瓶子相比，了解母亲对不透明瓶的接受和使用 不透明瓶改善基于家庭环境中喂养相互作用的结果的潜力。