OBSERVATION AND COMPARISON OF OBESE AND NORMAL-WEIGHT MOTHERS AND THEIR NEWBORN INFANTS DURING FEEDING.

摘要

The etiology and treatment of obesity are widely debated issues. Obesity that begins early in childhood is especially difficult to reverse. Consequently interest has focused on the genetic and familial antecedents of childhood obesity. Research has shown that obesity runs in family lines, probably for both genetic and environmental reasons. Further it appears that fat infants tend to become fat children, and, in turn, fat adults. The present study examined the behaviors of obese and normal mothers and their infants during feeding in order to explore early environmental factors that may contribute to the development of obesity.;Subjects were observed during two feedings around the infant's second day of life. First, all were videotaped during a feeding in the mother's room. Videotapes were scored with the Price Maternal-Infant Adaptation Scale. During a subsequent feeding, mothers fed their infants with a pressure-sensitive nipple that recorded the baby's sucking pattern while the mother's attempts to increase eating by jiggling the baby or bottle were simultaneously recorded. Dependent variables were the scores from the Price Scale; the amount consumed and duration for both meals; the rate of sucking, the duration of sucking bursts, the frequency of jiggling, and the percent of time spent jiggling for the second meal. Results were analyzed by mothers' size, infants' size (defined by a combination of anthropometric measures), parity, and infant sex.;Results revealed that the obese women had significantly fatter babies, and that the bigger babies consumed more and tended to be more alert. No behavioral differences related to maternal obesity were found when all the obese and all the normal mothers were compared. However, when the 10 most obese mothers were compared with the 10 thinnest, the fatter women tended to receive significantly higher, more adaptive scores on the Price Scale. There were no differences by infant sex. Multiparous mothers took significantly longer to feed their babies.;Additionally, as part of a pilot study, videotapes were made of 21 mothers, chosen without regard to weight, bottle-feeding their newborns. Fourteen were asked to feed just as they normally did. Seven were asked to "try a little harder to feed a little bit more." These videotapes were scored with the Price Scale. The request to feed more produced significantly lower adaptation scores.;Forty-eight bottle-feeding mothers and their full-term, healthy newborns served as subjects. Subjects formed two groups according to the degree of the mother's overweight. The obese-mothers group contained 25 mother-infant pairs, with obesity defined as triceps fatfolds at least one SD above average and 20 percent overweight for height and age. The normal-mothers group contained 23 subject pairs. Groups did not differ according to infant sex, maternal parity, SES, mode of delivery, or ethnicity.;Pilot study subjects came from a white, middle-class population, while obese-vs.-normal-study subjects were from a Hispanic, lower-class population. When these samples were compared, the results revealed significantly higher, more adaptive scores for the white, middle-class sample.;The results reveal few behavioral differences between obese and normal-weight mothers while feeding their babies during the early neonatal period, despite the sensitivity of the measures used to SES and to instructions to feed more. Therefore subsequent obesity in infants at risk because of parental obesity may be more a consequence of later feeding or of infant-directed possibly genetic overeating, reduced activity, or lower metabolic needs rather than mother-directed behaviors. Environmental factors no doubt affect the development of obesity, but which, if any, such factors operate in early infancy remains unknown.