Prevention of Obesity in Early Childhood
Oklahoma Native American EXPORT Center
University of Oklahoma Health Sciences Center

I do not have any financial arrangements or affiliations with any corporate organizations that might constitute a conflict of interest with regard to this continuing education activity.

(image: photo of 3 young boys and 3 young men)

Goal: Explore strategies to prevent overweight and obesity in infants & young children by promoting breastfeeding and healthy feeding practices.

• Infant Feeding Survey
• Intervention Study

Interview/Survey of mothers and/or caregivers on prevailing & past nutrition practice of 100 toddlers aged 12 to 35 months

Data collected was compared to the Feeding Infant and Children Study (Mathematica, 2002)

(image: bar graph titled "Caloric Intake for Percentile of Energy Requirement for Age (12-36 months)")

(image: bar graph titled "Toddler Consumption of Energy-dense Foods")

(image: bar graph titled "Toddler Beverage Consumption")

Breastfeeding initiation rate for babies born at the Lawton Indian Hospital was 52%, and an overall rate of 59%.

(image: pie graph titled "Breastfeeding Barriers")

(image: bar graph titled "Illnesses - Formula Fed vs. Breastfed")

• Breastfeeding initiation/duration rates are suboptimal
• Low daily intake of vegetables, fruits, and milk
• High intake of calorie-dense, low-nutrient foods
• Daily energy intake above recommended Estimated Energy Requirements

Pregnant Native American and Alaskan Native women are recruited to participant in a two-year study.

The study promotes breastfeeding and healthy feeding practices for infants and toddlers.

(image: photo of brochure titled "Prevention of Obesity in Early Childhood")

Current recruitment: 186 mothers

139 mothers have given birth to 144 babies (5 sets of twins)

129 babies have been breastfed for an initiation rate of 89.6%

(image: photo of a male toddler)

Expectant mothers, and their family members, attend a one-time class during pregnancy.

To date, 42 "Baby Feeding" classes have been offered, and 112 mothers and 45 guests have attended.

(image: two photos of expectant mothers attending "Baby Feeding" class)

Class topics include:

• Benefits of breastfeeding for mothers
• Benefits of breastfeeding for babies
• Demonstrations of positions and latching techniques
• Discuss breastfeeding myths, challenges and problem-solving treatments

(image: photos of a woman practicing a breastfeeding position and another learning how to pump breast milk)

(image: photo of two boys filling a bottle)

	Healthy People 2010 Goals	National Rates (2003)*	National Rates for AI & AN (2003)*	State of Oklahoma Rates (2003)*	EXPORT Survey Rates (2004)	EXPORT Pilot Study
Initiation Rates	75%	71%	69%	62%	52%	89.6%
Breastfeeding Duration at 6 months	50%	36%	32%	25%	28%	n/a
Breastfeeding Duration at 12 months	25%	17%	15%	9%	13%	n/a

* CDC's Breastfeeding National Immunization Data
http://www.cdc.gov/breastfeeding/

Breastfeeding initiation rate for babies born at the LIH for Pilot study participants is 94%, compared to 52% in the control group. The overall rate is 89% up from 59%.

(image: pie chart titled "Cohort Breastfeeding Barriers")

(image: bar graph titled "Survey vs. Cohort Breastfeeding Barriers")

• Maternal ages very young at 13 years and the average age is 24
• Lack of family support
• Lack of confidence in breastfeeding
• Phone service and transportation

"…recommends structured breastfeeding education and behavioral counseling programs to promote breastfeeding…"

The Guide to Clinical Preventive Services, 2005

Provide Accurate information

Consistent information

Before conception, and continue through baby's first year and beyond

(image: photo of a nurse helping a new mother breastfeed her baby)

(image: photo of a ram on a sheer cliff face)

(image: photo of happy baby)

Lactation Consultants
Breastfeeding Educators
WIC Clinics
can assist with
Time – Intensive
Challenges

(image: cover of "Passport To A Healthy Baby")

(image: inside pages of "Passport To A Healthy Baby")

(image: back cover of "Passport To A Healthy Baby")

(image: cover of "Medications and Mother's Milk" by Thomas W. Hale, Ph.D.)

"Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."

AAP Policy Statement, 2005

(image: photo of young mother with toddler)

"Complementary foods rich in iron should be introduced around 6 months of age."
(Range of 4 to 8 Months)

AAP Policy Statement, 2005

(image: poster "Eat a Rainbow Every Day")

• U.S. families spend $2 billion a year on formula
• $1.3 billion spent to cover sick-child visits and Rx for respiratory infections, ear infections, and diarrhea

The United States Breastfeeding Committee, 2002

Although breastfeeding is natural, it is not instinctive, it must be learned

A good breastfeeding relationship takes time.

(image: photo of happy baby girl)

(image: cover of "HHS Blueprint for Action on Breastfeeding")

(image: cover of "Breastfeeding Handbook for Physicians")

(image: American Academy of Pediatrics Work Group on Breastfeeding document titled "Breastfeeding and the Use of Human Milk")

"A newborn baby has only three demands…warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three."

Dr. Grantly Dick-Reed

Breastfeeding might not be the best choice for every parent, but…

Breastfeeding is the right choice for every baby!

(image: photo of sleeping infant wrapped in a bow with a tag that reads "From God!")

Mom gave me the Best

(image: photos of 23 children who were breastfed)

National Center on Minority Health and Health Disparities of the National Institutes of Health

Lactation Consultant Services^TM

Wichita/Caddo/Delaware WIC

USPHS Lawton Service Unit

• U.S. Department of Health and Human Services Office on Women's Health
• U.S. Library of Medicine, NIH
• American Academy of Pediatrics
• American College of Obstetricians and Gynecologists
• WHO/UNICEF

• www.bflrc.com
• www.4woman.gov
• www.womenshealth.com
• www.motherfriendly.org
• www.lalecheleague.org
• www.babymilkaction.org
• www.childbirthgraphics.com