September 30, 2013
Preventing the development of obesity in children is an international health priority. Here, we outline the inroads that researchers in the Centre for Physical Activity and Nutrition (C-PAN) at Deakin University are making into the issue of childhood health through The Melbourne Infant Feeding, Activity and Nutrition (InFANT) program.
The early years of life provide a one-off opportunity to establish healthy lifestyle behaviours. Starting children out with these behaviours rather than trying to change them later on is easier for all – prevention simply makes good sense. These early years are a time when parents are remarkably receptive and engaged in doing the best for their children.
Promoting healthy eating and activity behaviours in children has never been more important. By 18 months of age, most Australian children are consuming energy-dense foods and drinks daily. These displace fruits, vegetables, water, milk and other essential foods and are known to contribute to overweight and other health issues. Further, one in ten 18 month year olds watch more than two hours of television a day, despite government recommendations that children aged under two, spend no time watching television.
Eating and physical activity behaviours developed in early life influence these behaviours for the rest of life; and a child’s dietary behaviours track across early childhood, into adolescence and adulthood. This has significant implications for health across the life-course.
We know parents find the early years a challenge and describe it as a time when they need more support regarding how to promote healthy lifestyle behaviours in their children. We also know parents become less confident to influence their child’s lifestyle behaviours as their children move through the toddler years, and this is associated with less desirable child eating and activity behaviours.
Naturally, parents want to give their children the best start in life, and our research has shown that many are keen to meet with other parents to get peer-support, advice and strategies about how to feed and play with their babies and toddlers.
To support parents during this critical time, Deakin University developed the InFANT Program. The Program was trialled with 542 families across 11 Victorian Local Government Areas from 2008-2010.
The InFANT Program:
- Is a six session lifestyle program delivered to parents of young infants over the first 18 months of life within their existing social groups (first time parent groups). It’s a fully evaluated program that has shown that we can influence parent’s knowledge and self-efficacy (confidence), improve mother’s lifestyle behaviours and improve those of their young children.
- Aims to promote healthy eating and activity behaviours in parents and their children. Emphasis is placed on improving knowledge, skills and strategies known to promote healthy eating (feeding styles and food provided) and active play (physical activity and reduced screen time) across these first years. A strong emphasis is placed on parental modelling of healthy lifestyle behaviours.
- Helps parents explore the enablers and barriers to achieving healthy lifestyle behaviours for themselves and their children.
Working with parents across many months creates the opportunity to engage with them in an anticipatory way – with discussions reflecting children’s rapidly changing developmental phases. The philosophy behind anticipatory guidance is that information is provided before it is needed, and that this may help to support parents to engage in preferable behaviours from the start. Examples of this include focussing on how to promote preferences for healthy foods and drinks from the beginning; how to engage children in active play at all developmental phases; and how to provide alternatives to using television for stimulation.
Key results from the InFANT Program
Parent participation and engagement were high
- Eight out of 10 mothers attending first-time parent groups joined the InFANT Program, regardless of their socioeconomic position.
- Seven out of 10 mothers attended at least four of the six scheduled sessions.
- Process evaluation showed that around 85% of mothers, across socio-economic groups, consistently reported high levels of program usefulness and relevance.
Parental knowledge about, and self-efficacy to achieve, healthy infant eating and active play behaviours increased. Maternal diet improved.
Compared to mothers not involved in the InFANT Program, mothers in the Program:
- were less likely to agree that TV was educational or benefited their child’s learning
- had improved nutrition knowledge,
- were less likely to employ undesirable feeding practices (e.g. use of pressure in child feeding, use of food as rewards),
- reported higher levels of self-efficacy to limit their child’s consumption of unhealthy foods,
- had healthier dietary patterns.
Children’s diet improved and television viewing reduced
Compared to children not involved in the InFANT Program, children in the Program:
- watched less television,
- ate less non-core sweet snacks,
- consumed more fruit and water,
- had improved lifestyle patterns.