Healthy Start to Feeding Intervention
Condition: Weight, Body; Diet Habit
MeSH terms: Body Weight
Study type: Interventional

Summary: 
      The current study will test the impact of a 3-session obesity prevention program targeting
      healthy introduction of solid foods in infancy on growth trajectories, appetite regulation,
      and diet. The investigators will also test the feasibility and family satisfaction with the
      treatment. Healthy infants with normal and elevated weight-for-length will be enrolled in the
      study at 3 months of age and complete an initial study visit to assess baseline
      anthropometrics,demographics, parental feeding practices and beliefs, and infant appetite.
      Infants will than be randomly assigned to either the treatment condition (n = 20) or control
      condition (n = 20). Infants in the control condition will receive no intervention or further
      contact with the study team besides for completion of a final study assessment visit when the
      child is 9 months old. Infants in the treatment condition will receive a 3 session
      intervention targeting healthy introduction of solid foods, with study visits occurring when
      the child is 4 months, 6 months, and 9 months old. All families will complete a final study
      visit to complete post-treatment period measurements, which will include infant
      anthropometrics and parent-report of infant appetite, infant diet, and parental feeding
      practices and beliefs. Outcomes include: weight-for-length percentile, infant satiety
      responsiveness, infant food responsiveness, and infant fruit and vegetable consumption.
      Family satisfaction and treatment attendance will also be assessed.
    

Detailed description: 
      The purpose of this research study is to pilot test a prevention program to promote healthy
      introduction of solid foods and healthy weight gain among infants. Introduction of
      complementary foods (i.e., foods besides formula or breast milk) represents a major dietary
      milestone for infants. The current study will test the feasibility of a 3-session
      intervention encouraging healthy introduction of complementary foods and use of a responsive
      feeding approach. Feasibility of the intervention and the impact of the Healthy Start to
      Feeding (HSF) intervention on obesity risk factors and growth will be explored. This will be
      achieved through exploration of the following aims and hypotheses:

      Aim 1: Determine feasibility of the intervention and family satisfaction with the treatment.

      H1: Families assigned to the intervention condition will attend equal to or greater than 67%
      of treatment sessions.

      H2: Families receiving the intervention will rate the program as helpful and consistent with
      the families' needs and priorities.

      Aim 2: Test the impact of the HSF intervention on growth trajectories, appetite regulation,
      and diet at post-treatment.

      H1: Infants receiving the intervention will experience lower incidence of high
      weight-for-length (> 85th percentile) compared to infants in the control condition.

      H2: Infants in the treatment condition will show greater satiety responsiveness and lower
      food responsiveness as assessed through a well-validated parent-report measure (Baby Eating
      Behavior Questionnaire; Llewellyn, van Jaarsveld, Johnson, Carnell, & Wardle, 2010).

      H3: Infants in the treatment condition will consume a greater variety of fruits and
      vegetables than infants in the control condition as assessed through a food frequency
      questionnaire completed by parents.
    

Intervention name(s): Healthy Start to Feeding
Intervention type(s): Behavioral
Intervention description(s): The intervention provides parent education and skills training on a responsive feeding approach to introduction of healthy foods in infancy. Session content is manualized and administered by interventionists with expertise in child development and behavioral strategies for managing child eating behaviors under the supervision of a licensed clinical child psychologist and pediatric occupational therapist. Sessions are conducted individually with participants and primary caregivers and include educational content, handouts and instructions, modeling of skills by the interventionist, caregiver practicing of skills in session, establishment of behavioral goals, and problem solving barriers to implementation of treatment content. Content will include topics such as allowing infants' own hunger and satiety cues to guide the feeding experience, introducing healthy foods, parental attunement to infant satiety cues, and promoting infants' own self-feeding.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Infants will be assigned to either the treatment or control condition.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: obesity prevention; infant; complementary feeding; diet variety; weight-for-length; food responsiveness; satiety responsiveness