Child Care Factors in Weight Gain of Babies

Child Care Factors Associated with Infant Feeding Practices and Weight Gain Among U.S. Infants

A study from the Archives of Pediatric Adolescent Medicine found that, based on a nationally representative survey, child care factors, including type of child care and intensity, were associated with unfavorable infant feeding practices and weight gain during the first year of life.  The study examined 8,150 infants born in 2001 in the U.S., from the Early Childhood Longitudinal Study, Birth Cohort B, gathered by the U.S. Department of Education, National Center for Education Statistics.   

In this study, interviews were conducted in the child’s home when the child was nine months of age.  Initiation of breastfeeding was assessed with a yes or no and age at which formula or cow’s milk was introduced (child’s age in months) was recorded.  Analysis was adjusted for maternal BMI and the child’s birth weight, since both are potential confounders.  The study found that all child care factors assessed (including age of child at initiation of child care, type of child care, and intensity of child care) were significantly associated with infant feeding practices and weight gain; infants entering child care prior to three months of age were less likely to have breastfeeding initiation (odds ratio, 0.58; 95% CI, 0.43-0.74) and more likely to have early introduction of solid foods compared to infants in parental care.  However, the authors note that “we found no protective effect of breastfeeding on weight gain, in contrast to findings in other studies.”

This study has several strengths and limitations.  One strength is that this study is the first study to report a potential relationship between infant child care and infant nutrition and growth.  Additionally, the authors report that “a strength of our findings is that the observed effects of child care factors remained significant after controlling for maternal prepreganancy BMI and child’s birth weight.”  A limitation of this study is that it was cross-sectional, meaning the authors were unable to show the potential mediating role of infant feeding practices between the observed risk of child care and weight gain.  Furthermore, the study lacks data on the frequency, amount, and type of solid foods consumed by infants as well as detailed information on child care factors, such as nutrition and physical activity policies that could potentially have an important role in infant feeding practices and the risk of overweight.   The authors conclude that “more research is needed to understand the mechanisms by which these early child care factors and infant feeding practices affect subsequent risk for childhood overweight.”

Kim, J. and Peterson, K. E.  Association of Infant Child Care with Infant Feeding Practices and Weight gain Among U.S. Infants.  Arch Pediatr Adolesc Med, July 2008. 162 (7): p. 627-633.