About 17% of children in the United States are obese, and research has shown that obesity rates are consistently higher among Hispanic and African American children. Most obesity prevention interventions focus on school-age children and adolescents, even though more than half of those who become overweight or obese are already overweight by their second birthday.

In a 27-month randomized controlled study, researchers evaluated the impact of a home visiting parenting program, "Minding the Baby," for first-time mothers living in medically underserved communities. The researchers sought to determine if the interventional program would have an impact on childhood obesity and overweight rates in the first two years of life.

The "Minding the Baby" program entails weekly home visits by a social worker and a pediatric nurse from the mother's third trimester until the child's first birthday; then they make biweekly visits until the child is two years old. This program provides support for the physical and mental health of mothers and children. Although obesity prevention is not the primary aim of the program, social workers and nurses work with mothers to help them recognize their child's hunger cues and ways to engage during feedings, and they discuss issues such as nutrition and food preparation.

The study cohort included 158 children: 66 in the control group, and 92 in the intervention group. Data were collected when the children were two years old. Women in the control group received standard prenatal and primary care at community health clinics, whereas women in the intervention group received standard care but also participated in the "Minding the Baby" program. Nearly 70% of the women in this study self-identified as Hispanic.

At age two, 19.7% of the children in the control group were obese, compared with 3.3% of children in the intervention group, a statistically significant difference. Although at two years of age more children in the intervention group (16.3%) were overweight compared with those in the control group (13.6%), more children in the intervention group (78.3%) also had a normal body mass index compared with those in the control group (63.6%).

These results suggest that home visiting programs that focus on the early mother-child relationship using a socioecological approach may help to build a foundation for healthy development and reduce childhood obesity rates among children in high-risk groups.-EM

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