Pilot trial aims to reduce rapid weight gain and obesity risk among Latine infants

With $784,369 from the NIH, UNCG researchers will implement a pilot trial that aims to reduce rapid weight gain and obesity risk among Latine infants by supporting mothers in breastfeeding.

Childhood obesity is prevalent in the U.S and a pressing concern. While the overall obesity rate for children is around 20%, an estimated 25.6% of Hispanic children are obese, according to the Centers for Disease Control and Prevention. Children who are obese are at a higher risk for a
myriad of health conditions, including Type 2 diabetes, asthma, and high blood pressure.

Principal investigators Dr. Jigna Dharod and Dr. Jasmine DeJesus, associate professors in nutrition and psychology, respectively, say infant nutrition is very crucial for a child's long-term health.

Infancy is a very important lifestage. It's a highly developmental phase, and it's a phase of immense opportunities. At the same time, any vulnerabilities during this phase can have a lifelong impact."

Dr. Jigna Dharod, principal investigator

Breastfeeding without supplementation of formula or other foods – known as exclusive breastfeeding – during infancy correlates with less excess weight gain for the baby and a healthier weight throughout childhood, say the researchers.

In a past study, Dharod and DeJesus have found that formula-fed infants have a higher risk of rapid weight gain during their first year of life. Their work also indicates formula feeding ormixed breastfeeding and formula feeding is common among Latina mothers.

For some parents, breastfeeding may not be an option due to health-related or other insurmountable circumstances. Others may face a variety of barriers to exclusive breastfeeding, including lack of time, support, knowledge, and confidence. The pilot seeks to lower the barriers
the latter group faces.

"Previous literature shows that many times a mother's intentions are to continue with breastfeeding, but they stop prior to reaching it," Dharod says. "One of the key predictors of not being able to meet the goal is their low self-efficacy, or confidence, in their ability to
breastfeed."

Finances and government policies can also play a role in some mothers' decisions about breastfeeding. Through the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children program (WIC), low-income parents can opt into
different packages depending on whether they are breastfeeding or formula feeding their infant.

"The monetary value of WIC's breastfeeding package is much lower than the formula assistance package," Dharod says. "In the formula assistance package, families receive a few hundred dollars' worth of infant formula, while in the exclusive breastfeeding mothers receive extra supplemental foods of about $75."

DeJesus and Dharod designed their multicomponent randomized trial to help tackle some of these barriers and provide needed support to parents looking to breastfeed more or for a longer duration. The study will randomly assign Latina women recruited from Cone Health clinics into control or treatment groups.

Trained peer counselors will provide house visits and support to the 60 mothers enrolled in the treatment group. Participants will also receive a breast pump or cash, depending on their preference. Support will be tailored to parents' needs, preferences, and language.

"What's most novel about our approach is to have culturally matched and bilingual peer counselors," says DeJesus. "A peer counselor, especially one who speaks the same language as participants, can provide knowledge that can be helpful in navigating challenges that people might experience with breastfeeding."

The researchers will compare whether the mothers with this support have higher rates of exclusive breastfeeding and self-efficacy compared to the control group. They will also track the infants' weight gain and obesity risk across the first six months of their lives.

Throughout the study, the researchers will conduct a process evaluation to determine which aspects of the intervention are effective, refining their methodology for a future large-scale trial.

"We know that exclusive breastfeeding is the number one strategy to reduce obesity risk, but how feasible is it to deliver the intervention? What helps improve the uptake of that intervention?" Dharod says.

They say their findings could have long-term policy implications.

"In addition to learning something scientifically about the experiences of breastfeeding, we also have the power to actually help people and that's something that's really exciting to me," DeJesus says.