Responsive parenting may help reduce behaviors linked to childhood obesity

One in five children in the United States has obesity, which is a significant predictor of chronic health problems later in life.

Infants who gain excessive weight prior to their second birthday are at an increased risk of developing obesity in childhood, especially those who are encouraged to finish all of their food even after expressing fullness, according to researchers from the Penn State Department of Nutritional Sciences and Geisinger College of Health Sciences.

The research team recently demonstrated that mothers who received responsive parenting guidance better identified and responded to their children’s needs and reported fewer behaviors that could contribute to their child’s risk of obesity.

The study—led by Yining Ma, nutritional sciences doctoral student, Jennifer Savage Williams, professor of nutritional sciences and director of the Center for Childhood Obesity Research, and Lisa Bailey-Davis, professor of population health sciences and the director of the Center for Women’s & Children’s Research at Geisinger College of Health Sciences—is published in Pediatric Obesity.

“Responsive parenting helps moms and caregivers to be in tune with their baby and correctly identify their baby’s needs to respond in a supportive and nurturing way,” Ma said. “For new parents, recognizing signs of hunger or tiredness in their baby can be challenging. When these cues are missed or misread, it can sometimes lead to overfeeding, which may contribute to excessive weight gain.”

The researchers used data from 288 mother-infant pairs from low-income households in the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care study, a clinical trial led by Savage Williams and Bailey-Davis that tested how integrated care between pediatricians and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) nutritionists supported educating mothers in responsive parenting.

Mothers in the six-month-long study received either responsive parenting intervention with coordinated care between pediatricians and WIC nutritionists or standard care at well-child visits. The responsive parenting intervention included guidance on infant feeding, soothing, sleep and interactive play.

Mothers in both groups completed a lifestyle risk assessment at the infant’s two-month and six-month wellness visits, answering questions about their infants’ feeding practices, obesity-promoting risk behaviors, sleep, interactive parent-child play, appetite traits and relationships with caregivers. The results of these assessments were integrated into the electronic health records to facilitate personalized counseling for the mothers.

“The Early Healthy Lifestyles (EHL) screening tool used to assess lifestyle risk allowed us to target a combination of obesity risk behaviors at developmentally relevant times to better help mothers with their unique needs rather than focusing on a single behavior,” Bailey-Davis said.

Mothers who received the responsive parenting intervention were found to be less likely to pressure their infant to finish a bottle, put their child to bed after 8 p.m., and to use devices like a smartphone or TV when feeding or playing with their child. They also reported fewer nighttime feedings. The authors developed a total obesity risk behavior score for all mother-infant pairs, finding that those in the intervention group had significantly lower scores at two months compared to those receiving standard care, though this difference was not seen at six months.

“Our main finding demonstrated the effectiveness of responsive parenting behaviors in reducing the obesity-promoting risk for children during the first two months of infancy,” Savage Williams said. “The education that WEE Baby Care’s intervention provided helped mothers better understand their baby’s cues and needs and how to respond appropriately to them.”

The researchers also noted that this study demonstrated the effectiveness of using coordinated care across health care settings to reduce obesity risk during infancy.

The research team plans to continue investigating the utility of the EHL risk assessment tool as a practical resource for practitioners to identify obesity risk behaviors during infancy and the patterns of obesity risk behaviors on infant weight status.

“For many families, especially those with limited access to educational resources, programs like WEE Baby Care and WIC provide vital support in helping caregivers learn babies’ behavior cues and building confidence in caring for a new baby,” Ma said.

Amy Moore, assistant professor of nutritional sciences, also contributed to this research.