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Infant weighing, feeding and the obesity epidemic
- Ruth V Reed (26 August 2008)
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Ruth V Reed, Specialty Registrar in Child and Adolescent Psychiatry MRCPCH
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ruthvreed{at}gmail.com Ruth V Reed
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From my recent journey into parenthood, I have gained some worrying insights into the roots of obesity in infancy. Ideally, the nation’s breastfeeding rates would be far higher, but we must address the current reality that the majority of babies are primarily formula-fed for most of their first year. Numerous inappropriate bottle-feeding practices leading to excessive calorie intake are widespread, and health professionals must make efforts to recognise and advise parents against these obesity- promoting behaviours. In a major supermarket, I saw ‘newborn bottles’ with an incredibly inappropriate 300ml capacity. The mothers of bottle-fed babies whom I know, however well-versed in child health, invariably make up far more formula on each occasion than their child could possibly consume. Encouraged by the excessively large containers to prepare equally excessive volumes of formula , mothers continue to offer the bottle beyond the natural end of the baby’s feed, often exceeding the one-hour period after which milk should be discarded. Secondly, I have met many highly-educated but non-medical new mothers who completely misunderstand the implications of centile charts. It is universally perceived as a good thing and often a boasting point if children cross their centiles upwards. Parents are greatly concerned if their children track any centile lower than their birthweight centile, however healthy or well-nourished the infant. Women are encouraged by health visitors to weigh perfectly normal babies each week and understandably become worried about minute variations in patterns of weight gain, such as are seen following minor illnesses. Several mothers I know have followed health visitors’ advice to abandon or supplement breastfeeding after minimal, and probably appropriate, downward deflections from high initial centiles. The drive to promote and normalise breastfeeding should not distract health visitors and paediatricians from their duty to ensure that parents understand the nutritional needs and weight gain patterns of their infants, whatever their method of feeding. Furthermore, we should not encourage parents to weigh infants at unduly short intervals that can only lead to unwarranted concern and intervention for normal variations in weight gain. |
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