UK surveys show that more than one in five children are overweight or obese by the time they start school. Nutrition and growth during infancy can also have long term effects on eating behaviours and risks of obesity in later life.
Assessing early intervention
Through systematic reviews of the evidence and a new trial, CEDAR and MRC Epidemiology Unit researchers are learning more about how we might prevent obesity by intervening during infancy. Very little research had previously looked at how best to protect the health of bottle fed babies, who often gain weight rapidly and tend to be at higher risk of childhood obesity. Our researchers have therefore identified formula milk feeding as an area for intervention.
“Although around 80 per cent of mums start to breastfeed their baby, within six weeks some 78 per cent of mums are supplementing breastfeeds with some bottle feeds,” says CEDAR investigator Dr Raj Lakshman.
“Evidence still suggests that breastfeeding is the best way of ensuring optimal health for mother and baby, but the needs of bottle feeding mothers need to be better answered to avoid risks to their babies’ health.” Our first systematic review in this area looked at how parents decide on quantities and frequency of formula milk feeds. It also revealed that mothers who bottle feed reported many negative emotions such as guilt, uncertainty, anger and a sense of failure for not breastfeeding. Mothers further reported that they did not receive enough information and support from healthcare professionals when it came to bottle feeding, and mistakes in feed preparation were common. Indeed, our second systematic review identified that improving the quality of the advice given by healthcare providers appeared to be important in helping parents follow infant feeding guidelines.
A randomised controlled trial
Building on the learning from the systematic reviews, our researchers worked with mothers and healthcare professionals to develop a feeding programme which aims to support families who use formula milk in order to achieve a healthy pattern of growth and weight gain for the babies. The infant feeding programme is being tested in a randomised controlled trial. One group is being given advice and support to follow the new guidelines for formula milk feeding. The other group is being given routine advice about formula milk feeding and weaning. These two approaches can then be compared to test the feasibility and effectiveness of the new feeding programme. The babies in the two groups will be followed up during the first 12 months of life. The results of the study will inform infant feeding guidelines in the UK and will help us understand the links between infant feeding, behaviour, growth and future obesity risk.
More information at www.mrc-epid.cam.ac.uk/Research/Studies/BabyMilk