Early child care and adiposity at ages 1 and 3 years.
BACKGROUND
The majority of infants in the United States are in nonparental child care, yet little is known about the effect of child care on development of obesity.


OBJECTIVE
To examine the relationship between child care attendance from birth to 6 months and adiposity at 1 and 3 years of age.


METHODS
We studied 1138 children from a prospective cohort of pregnant women and their offspring. The main exposure was time in child care from birth to 6 months of age, overall and by type of care: (1) child care center; (2) someone else's home; and (3) child's own home by nonparent. The main outcomes were weight-for-length (WFL) z score at 1 year and BMI z score at 3 years of age.


RESULTS
A total of 649 (57%) infants attended child care; 17% were cared for in a center, 27% in someone else's home, and 21% in their own home by a nonparent. After adjustment for confounders, overall time in child care was associated with an increased WFL z score at 1 year and BMI z score at 3 years of age but not skinfold thicknesses. Center and own home care were not associated with the outcomes, but care in someone else's home was associated with an increase in both the 1- and 3-year outcomes.


CONCLUSIONS
Child care in the first 6 months of life, especially in someone else's home, was associated with an increased WFL z score at 1 year and BMI z score at 3 years of age.
Benjamin
Sara E
SE
Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA. sara_benjamin@harvardpilgrim.org
Rifas-Shiman
Sheryl L
SL
Taveras
Elsie M
EM
Haines
Jess
J
Finkelstein
Jonathan
J
Kleinman
Ken
K
Gillman
Matthew W
MW
D015992:Body Mass Index; D001942:Breast Feeding; D002654:Child Care / Q000706:statistics & numerical data*; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012885:Skinfold Thickness; D013223:Statistics as Topic; D015430:Weight Gain