Beginning at birth: Comprehensive findings from a prospective nutrition intervention in pediatric primary care

Introduction: Incident obesity among young black and Hispanic children remains a compelling public health concern. With body weight trajectory established in early life relating profound implications for family health, obesity prevention beginning in early infancy is needed. Methods: This prospective intervention changed the clinical environment bringing obesity-focused primary prevention to mother-baby dyads (n=282 to-date) in an urban primary care clinic. Recruited within the baby’s first two weeks of life and assigned to the intervention or standard pediatric care, intervention dyads are seen by a dietitian and physician within the clinic visit who together monitor weight gain, feeding habits (inclusive of breastfeeding support), and provide nutrition counseling appropriate to the baby’s developmental stage and maternal needs designed to increase the proportion with healthy weight-for-length through age two. Socioecologically-guided factors impacting weight and health are collected at baseline, 6-, 12-, 18-, and 24-months and combined with electronic medical records to enable comprehensive comparisons between groups throughout the study period. Results: A diverse (68.4% Hispanic, 13.1% black), high-need (31.5% food insecure) sample enrolled at baseline. Initial breastfeeding update is common (75.2%) with strong self-efficacy for breastfeeding reported (M=4.26/5). 6-month data collection is being finalized and 12-month mother-baby dyad data will also be available which collectively will illuminate intervention factors associated with favorable infant weight-for-length trajectory and maternal health. Discussion: Provision of comprehensive nutrition education and obesity prevention in a primary care clinic is feasible and holds promise for positively impacting the health of diverse families