How Have They Grown? Six month outcomes on preventing child obesity through home visits

Purpose/Aims: The goal of research study being presented here (title blinded) is to see if home visits by promotoras can prevent obesity from developing in a sample of infants in a population of low-income WIC participants of Mexican descent in a southern state. Child obesity (weight for length among children less than 2 years of age) has not been widely documented in low-income Latino children. However, older Latino children are among those with the highest rates of obesity. Home visits by para-professionals (promotoras/community health workers) have not been investigated for their efficacy in addressing a national problem within the Latino population.

Methods: Pregnant women of Mexican descent whose pre-pregnancy BMIs were 25 or greater were recruited during their last trimester of pregnancy to participate in the study. After baseline data were collected, the mothers were randomly assigned to receive educational promotora home visits or only data-collection home visits by a blinded data collector. At the home visits, the promotoras provided breastfeeding support and teaching on appropriate child nutrition, positive parenting behaviors, infant sleep hygiene, physical activity for infants. The data presented here are for 6 months after the child’s birth. Anthropometric data was collected at each visit. Food stamp use data is based on a yes/no question regarding the participant’s involvement with the program. Breastfeeding data was obtained from a questionnaire about growth and nutrition. The question, “Are you using breast, bottle, or cup” allowed for up to three responses. Those selecting breast or bottle were prompted to provide, in number of weeks, how long they had been using those methods.

Results: When the infant was six months old the measures were obtained from a sample of 119 mother/infant pairs (intervention=63; control = 56) to examine differences between the intervention and control groups. Although not statistically significant at this time, the intervention group has a lower weight for height Z score and percentile than does the control group at six months of age. Neither group shows a prevalence of weight for length percentile approaching 85%.

Implications: Contrary to our expectations, home-based breastfeeding support did not result in significant increase in the breastfeeding prevalence among the intervention group nor did it lessen the amount of bottle-feeding that occurred along with breastfeeding. The control group actually had lower rates of bottle-feeding and supplementing breastfeeding with bottle-feeding. No statistically significant differences were seen in the mothers’ sensitivity to infant feeding cues. Many overwhelming social issues have emerged during the course of the home visits to the extent that child feeding is a lesser issue than finding stable housing, employment, weekly food, etc. The rate of food insecurity is high among the sample.