WIC educators’ impressions of infant and toddler feeding practices that may lead to childhood obesity

Obesity rates among low-income children in the U.S. are higher than those of their higher-income counterparts. New Jersey’s WIC-enrolled children have maintained a rate of obesity that is far above the national average. Consequently, obesity prevention has become a focus of several public health programs. Within NJ, both WIC and SNAP-Ed programs aim to provide low-income populations with educational resources to combat the rise of obesity among NJ’s youth. The aim of this study was to identify the child feeding practices utilized by low-income, diverse parents and caregivers in NJ that may lead to infant and toddler overweight and obesity. Semi-structured, open-ended interviews were conducted with nutritionists and breastfeeding counselors at 8 NJ WIC agencies. At the close of each interview, participants were presented with a list of prompts compiled based on a review of potentially obesogenic child feeding practices found the literature. Data were coded using computer assisted qualitative data analysis software (NVIVO). Thirty-two (N=32) WIC staff members were interviewed, with interview times ranging in length from 16-43 minutes. A total of 22 feeding practices were identified, from which 4 themes emerged: feeding practices that support excessive energy intake; inappropriate bottle feeding practices; instrumental feeding practices (i.e., use of food as a reward or punishment); and, suboptimal food/beverage choice. Despite the high level of diversity among NJ WIC’s clientele, the feeding practices employed by them were found to be similar. While the majority of feeding practices found in this study were previously recognized in the literature as potentially associated with childhood obesity, two unique findings indicate that caregivers may benefit from education addressing infant rooting and sucking reflexes and on the contents and intended uses for nutritional supplements, as well as media literacy of nutritional supplement ads. Future research should explore the impact of nutrition supplement marketing on parents and caregivers and investigate intervention efforts that will lead to awareness and behavior change.M.S.Includes bibliographical referencesby Erika J. Lannama