Starting Obesity Prevention in Infancy: The Fit WIC Baby Behavior Study

Prior research among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) revealed that mothers believed breastfeeding was best for their infants; yet, many also believed early introduction of formula and solid foods was needed to address perceived indicators of infant hunger such as infant crying or night waking. A curriculum and educational tools were developed to help WIC families understand normal baby behavior. Eight WIC clinics were matched on several characteristics. Half were assigned randomly to an intervention group and the others served as controls. Staff members were trained to promote positive interactions between caregivers and infants. Educational materials were developed to reinforce study messages. Data were collected on staff and participants' knowledge and attitudes, infant-feeding practices, food package distribution and infant weight. Results indicated that infant-feeding behaviors were influenced by the intervention, particularly in the first 4 months postpartum. Intervention clinics reported an average increase of about 6% in distribution of the exclusive breastfeeding package as compared to about 1% in the control group. Combination feeding decreased in the intervention clinics among infants from 0 to 4 months while results for exclusive formula feeding were mixed. At the end of the study, significantly fewer infants in the intervention group were above the 95th percentile for weight-for-age as compared to those in the control group (4.9 versus 12.6%). Baby Behavior education may be important in efforts to prevent childhood obesity by reducing parents' unrealistic expectations about infant behavior that may lead to inappropriate feeding.