title: Outcomes of an early feeding practices intervention to prevent childhood obesity.
abstract: OBJECTIVE
  The goal of this study was to evaluate outcomes of a universal intervention to promote protective feeding practices that commenced in infancy and aimed to prevent childhood obesity.
  
  
  METHODS
  The NOURISH randomized controlled trial enrolled 698 first-time mothers (mean ± SD age: 30.1 ± 5.3 years) with healthy term infants (51% female) aged 4.3 ± 1.0 months at baseline. Mothers were randomly allocated to self-directed access to usual care or to attend two 6-session interactive group education modules that provided anticipatory guidance on early feeding practices. Outcomes were assessed 6 months after completion of the second information module, 20 months from baseline and when the children were 2 years old. Maternal feeding practices were self-reported by using validated questionnaires and study-developed items. Study-measured child height and weight were used to calculate BMI z scores.
  
  
  RESULTS
  Retention at follow-up was 78%. Mothers in the intervention group reported using responsive feeding more frequently on 6 of 9 subscales and 8 of 8 items (all, P ≤ .03) and overall less controlling feeding practices (P < .001). They also more frequently used feeding practices (3 of 4 items; all, P < .01) likely to enhance food acceptance. No statistically significant differences were noted in anthropometric outcomes (BMI z score: P = .10) nor in prevalence of overweight/obesity (control 17.9% vs intervention 13.8%; P = .23).
  
  
  CONCLUSIONS
  Evaluation of NOURISH data at child age 2 years found that anticipatory guidance on complementary feeding, tailored to developmental stage, increased use by first-time mothers of "protective" feeding practices that potentially support the development of healthy eating and growth patterns in young children.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia. daniels@qut.edu.au
authors.forename: Lynne Allison
authors.initials: LA
authors.lastname: Daniels
authors.forename: Kimberley Margaret
authors.initials: KM
authors.lastname: Mallan
authors.forename: Jan Maree
authors.initials: JM
authors.lastname: Nicholson
authors.forename: Diana
authors.initials: D
authors.lastname: Battistutta
authors.forename: Anthea
authors.initials: A
authors.lastname: Magarey
mesh_terms: D000886:Anthropometry; D001315:Australia; D015992:Body Mass Index; D002675:Child, Preschool; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005518:Food Preferences; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers / Q000193:education*; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D050177:Overweight / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires
keywords: childhood obesity; feeding practices; infant; randomized controlled trial