Beginning obesity prevention before birth in a U.S./Mexico border community

Background: Optimal gestational weight gain followed by breastfeeding may aid in preventing childhood obesity. This study tested feasibility and acceptability of an intervention designed to promote optimal gestational weight gain and intention to breastfeed. Methods: First-time, pregnant women at a community health center near the U.S./Mexico border attended weekly promotora-led group exercise, nutrition & breastfeeding activities (n= 23). We explored text messaging vs. social media for support between classes. Assessments included height, weight, nutrition, physical activity, and breastfeeding knowledge and beliefs. Results: Most participants were U.S. born (73%), preferred Spanish (83%), had high school education or less (65%), and were overweight/obese (56%). Change in beliefs/knowledge about nutrition, exercise and intention to breastfeed were observed and 100% of participants stated they would recommend this program to a friend. A private social media group was a more feasible form of out-of-class communication than text messaging. Attendance varied due to transportation and family/life conflicts. Other barriers included beliefs about safe exercise during pregnancy and low adherence to self-monitoring tasks. In the second component of this study, the intervention continues during the first post-partum year to support return to pre-pregnancy weight and optimal infant weight gain. Conclusions: An intervention to promote optimal weight gain in pregnancy was well received and resulted in changes in beliefs and knowledge. Coordination of group activities with prenatal visits and transportation support could improve feasibility. Beginning obesity prevention during pregnancy, in high-risk populations, holds promise as a way to influence birthweight and encourage healthy behaviors in first-time mothers.