RESUMEN

A growing, global conversation, regarding realities and challenges that parents experience today is ever-present. To understand recent parent's attitudes, beliefs, and perceptions regarding infant feeding, we sought to systematically identify and synthesize original qualitative research findings. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) framework, electronic databases were searched with a priori terms applied to title/abstract fields and limited to studies published in English from 2015 to 2019, inclusive. Study quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) checklist, and thematic analyses performed. Of 73 studies meeting inclusion criteria, four major themes emerged. (1) Breastfeeding is best for an infant; (2) Distinct attitudes, beliefs, and perceptions of mothers that breastfeed, and those that could not or chose not to breastfeed, are evident; (3) Infant feeding behaviors are influenced by the socio-cultural environment of the family, and (4) Parent's expectations of education and support addressing personal infant feeding choices from health care providers are not always met. This systematic review, guided by constructs within behavioral models and theories, provides updated findings to help inform the development of nutrition education curricula and public policy programs. Results can be applied within scale-up nutrition and behavioral education interventions that support parents during infant feeding.

RESUMEN

Healthy growth during the first 1,000 days, spanning from conception to age 24 months, represents a crucial period which influences the long-term physical and cognitive development of individuals. International public health recommendations and nutrition education interventions targeting early life focus on building individuals' capacities through a variety of educational strategies, accompanied by environmental support, with an ultimate goal being the voluntary adoption of food choices and other nutrition-related behaviors conducive to health and wellness of the expectant mother during pregnancy, parents and caregivers who have a role in feeding the infant, and the infant in later childhood and beyond. Nutrition education interventions that hold promise in the promotion of healthy infant growth are designed on the basis of applicable theory of health behavior, focus on multiple modifiable nutrition-related behaviors, and address various mediators, such as motivators and barriers relevant to acting on these modifiable behaviors. A limited number of randomized controlled trials have been published to date, with modest effect sizes, some of which show sustained benefits related to obesity prevention. Considerations related to intervention design, behavior change strategies, and scale-up efforts are needed to improve the efficacy of nutrition education strategies in early nutrition.

Asunto(s)

RESUMEN

Worldwide, the prevalence of childhood obesity has increased, amounting to 42 million overweight or obese children, and there is increasing evidence that the origins are within the first 1,000 days: the period of conception through 2 years. Antecedents of early childhood obesity are multifactorial, and associations of varying strength have been documented for genetic/epigenetic, biologic, dietary, environmental, social, and behavioral influences. Modifiable factors in pregnancy and early infancy associated with childhood obesity include maternal overweight/obesity, maternal smoking, gestational weight gain, infant and young child feeding, caregiver responsive feeding practices, as well as sleep duration, and physical activity. Promising obesity prevention interventions include those beginning during the first 1,000 days, using a multicomponent approach, with roots in nutrition education theories or behavior change communication that can continue over time. However, the limited number of completed interventions to date (within pediatric clinics or in home-based or community settings) may not be scalable to the magnitude needed for sustainable obesity prevention. Scale-up interventions that can be maintained for the durations needed, addressing infant and young child feeding and other modifiable risk factors associated with childhood obesity are needed.

Asunto(s)

RESUMEN

Interventions targeting parenting focused modifiable factors to prevent obesity and promote healthy growth in the first 1000 days of life are needed. Scale-up of interventions to global populations is necessary to reverse trends in weight status among infants and toddlers, and large scale dissemination will require understanding of effective strategies. Utilizing nutrition education theories, this paper describes the design of a digital-based nutrition guidance system targeted to first-time mothers to prevent obesity during the first two years. The multicomponent system consists of scientifically substantiated content, tools, and telephone-based professional support delivered in an anticipatory and sequential manner via the internet, email, and text messages, focusing on educational modules addressing the modifiable factors associated with childhood obesity. Digital delivery formats leverage consumer media trends and provide the opportunity for scale-up, unavailable to previous interventions reliant on resource heavy clinic and home-based counseling. Designed initially for use in the United States, this system's core features are applicable to all contexts and constitute an approach fostering healthy growth, not just obesity prevention. The multicomponent features, combined with a global concern for optimal growth and positive trends in mobile internet use, represent this system's future potential to affect change in nutrition practice in developing countries.

Asunto(s)

RESUMEN

Gut microbiota constitute a highly complex ecosystem that interacts with the host and profoundly affects gastrointestinal and systemic immunologic functions. Specific microbial patterns are associated with healthy children and adults, and these patterns are greatly related to the early acquisition of microbes by the newborn and the development of gut microbial communities in the perinatal period. Although direct causation must be firmly established and mechanisms fully elucidated, strong and increasing evidence shows that the early acquisition, development, and maintenance of specific bacterial populations are critical to human health, and a better understanding of these offers great opportunities for intervention.

Asunto(s)

RESUMEN

Several factors leading to obesity have been identified, which start at very early stages of life. Although there are genetic contributors and socioeconomic and racial disparities in the prevalence of overweight and obesity, the problem is universal. Children's weight has been associated to multiple specific diet factors and these, in turn, are associated to specific "parent feeding practices" (PAPP, Spanish abbreviation). Parents or caretakers determine patterns that are set at an early stage in life, and the weight before the first two years of age already predicts future overweight and obesity. Absence of breastfeeding and low food quality, consumption patterns and food preferences in the first two years of life are highly associated to PAPP and can, therefore, be modified. In this article, we will examine the diet factors and the diet-related practices that have been associated to child obesity, and are potentially modifiable, so that they can be used as a potential guide for intervention goals in the prevention of child obesity.

Asunto(s)

RESUMEN

Son varios los factores identificados que llevan a la obesidad, cuyo origen se da desde etapas muy tempranas de la vida. Aunque existen contribuyentes genéticos y disparidades socioeconómicas y raciales en la frecuencia de sobrepeso y obesidad, el problema es universal. El estado ponderal de los niños se ha asociado con múltiples factores dietéticos específicos y estos, a su vez, están asociados con específicas “prácticas de alimentación por parte de los padres” (PAPP). Los padres o cuidadores determinan patrones que se establecen muy temprano en la vida, y el peso antes de los dos años de vida predice ya el sobrepeso u obesidad futura. La falta de lactancia materna y la baja calidad de los alimentos, los patrones de consumo y las preferencias por alimentos en los primeros dos años de vida, son altamente dependientes de las PAPP y, por tanto, son también modificables. En este artículo vamos a examinar los factores dietéticos y las prácticas relacionadas con la dieta que han sido asociadas con la obesidad infantil, y que son potencialmente modificables, de forma que sirvan como guía potencial para metas de intervención, en la prevención de la obesidad infantil.

Several factors leading to obesity have been identified, which start at very early stages of life. Although there are genetic contributors and socioeconomic and racial disparities in the prevalence of overweight and obesity, the problem is universal. Children’s weight has been associated to multiple specific diet factors and these, in turn, are associated to specific “parent feeding practices” (PAPP, Spanish abbreviation). Parents or caretakers determine patterns that are set at an early stage in life, and the weight before the first two years of age already predicts future overweight and obesity. Absence of breastfeeding and low food quality, consumption patterns and food preferences in the first two years of life are highly associated to PAPP and can, therefore, be modified. In this article, we will examine the diet factors and the diet-related practices that have been associated to child obesity, and are potentially modifiable, so that they can be used as a potential guide for intervention goals in the prevention of child obesity.

Asunto(s)

RESUMEN

Childhood obesity is currently one of the most prevailing and challenging public health issues among industrialized countries and of international priority. The global prevalence of obesity poses such a serious concern that the World Health Organization (WHO) has described it as a "global epidemic." Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns, dietary habits, and parental feeding practices are established. Obesity prevention evidence points to specific dietary factors, such as the promotion of breastfeeding and appropriate introduction of nutritious complementary foods, but also calls for attention to parental feeding practices, awareness of appropriate responses to infant hunger and satiety cues, physical activity/inactivity behaviors, infant sleep duration, and family meals. Interventions that begin at birth, targeting multiple factors related to healthy growth, have not been adequately studied. Due to the overwhelming importance and global significance of excess weight within pediatric populations, this narrative review was undertaken to summarize factors associated with overweight and obesity among infants and toddlers, with focus on potentially modifiable risk factors beginning at birth, and to address the need for early intervention prevention.