Leann Birch

University of Georgia | UGA · Department of Foods and Nutrition

Responsive parenting (RP) interventions reduce rapid infant weight gain but their effect for underserved populations is largely unknown. The Sleep SAAF (Strong African American Families) study is a two-arm randomized clinical trial for primiparous African American mother-infant dyads that compares an RP intervention to a child safety control over t...

Objective The aim of this study was to test whether the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention, delivered to parents of firstborn children, is associated with the BMI of first- and second-born siblings during infancy. Methods Participants included 117 firstborn infants enr...

Obesity is a highly heritable condition that affects increasing numbers of adults and, concerningly, of children. However, only a small fraction of its heritability has been attributed to specific genetic variants. These variants are traditionally ascertained from genome-wide association studies (GWAS), which utilize samples with tens or hundreds o...

Background: INSIGHT tested an early life responsive parenting (RP) intervention designed for obesity prevention. BMIz at age 3 years was lower for the RP group versus controls with a larger effect for girls than boys. We sought to determine if child sex was associated with differing maternal feeding practices and whether sex moderated intervention...

Expert guidance encourages interventions promoting structure-based practices to establish predictable eating environments in order to foster children's self-regulatory skills. However, few studies have examined whether and how child characteristics may moderate effects of interventions on maternal feeding practices. This analysis aimed to examine t...

Background: Although previous work has shown that children with older siblings tend to have poorer diet quality, no study has directly compared diets of infant siblings. Objective: The goals of this analysis were to examine birth-order differences in dietary intake between firstborn (FB) and secondborn (SB) siblings, and to determine whether a r...

Background Child emotional overeating is a risk factor for obesity that is learned in the home environment. Parents' use of food to soothe child distress may contribute to the development of children's emotional overeating. Objectives To examine the effect of a responsive parenting (RP) intervention on mother‐reported child emotional overeating, a...

Background: The Intervention Nurses Start Infant Growing on Healthy Trajectories (INSIGHT) study's responsive parenting (RP) intervention, initiated in early infancy, prevented the use of nonresponsive, controlling feeding practices and promoted use of structure-based feeding among first-time parents compared with controls. Objectives: We sought...

Abstract Background Use of food to soothe infant distress has been linked to greater weight in observational studies. We used ecological momentary assessment to capture detailed patterns of food to soothe and evaluate if a responsive parenting intervention reduced parents’ use of food to soothe. Methods Primiparous mother-newborn dyads were randomi...

Background: Responsive parenting interventions that shape parenting behaviors in the areas of sleep and soothing, appropriate and responsive feeding, and routines represent a promising approach to early obesity prevention and have demonstrated effectiveness in our previous trials. However, this approach has yet to be applied to the populations mos...

Young children with T1D frequently display challenging eating behaviors interfering with diabetes management. The current study explored the feasibility and acceptability of a behavioral parent feeding training session with young children with type 1 diabetes. As part of a larger intervention pilot focused on healthy eating and physical activity, 9...

Objectives: To explore the discordance of maternal feeding practices by birth order and weight status between FBs participating in the Intervention Nurses Start Infants Growing on Health Trajectories (INSIGHT) trial and their secondborn (SB) siblings. Methods: Structure and control-based parent feeding practices were assessed at 1 year in FBs an...

Obesity is highly heritable, yet only a small fraction of its heritability has been attributed to specific genetic variants. These variants are traditionally ascertained from genome-wide association studies (GWAS), which utilize samples with tens or hundreds of thousands of individuals for whom a single summary measurement (e.g., BMI) is collected....

Responsive parenting is a promising framework for obesity prevention, yet attempts to date have largely relied on parents accurately interpreting their child's cues. Infant signing or “baby sign language” could enhance these interventions by improving bidirectional parent‐child communication during the preverbal and emerging language years. In a cl...

Background: Peak bone mass accrual occurs during adolescence, a time when dieting and related eating behaviors are common. Impaired bone mineral accrual is a known consequence of eating disorders in adolescents, but the effects of subclinical dieting behaviors on bone mineral content (BMC) have not been described in this age group. The goal of thi...

Introduction Prevalence of obesity is high among women of reproductive age. Excessive weight gain during pregnancy and postpartum weight retention (WR) are contributing factors. Differences in maternal weight retention and body composition have previously been linked to differences in infant feeding mode; whether the infant is breastfed or formula...

Gut and oral microbiota perturbations have been observed in obese adults and adolescents; less is known about their influence on weight gain in young children. Here we analyzed the gut and oral microbiota of 226 two-year-olds with 16S rRNA gene sequencing. Weight and length were measured at seven time points and used to identify children with rapid...

Objective: Maternal return to work within 12 weeks of delivery is associated with poor child health and development. However, little is known about the impact of return to work on child obesity risk. We examined whether timing of maternal return to work is associated with rapid infant weight gain from 0-6 months and weight-for-length at 1 year. M...

Background: What, when, how, how much, and how often infants are fed have been associated with childhood obesity risk. The objective of this secondary analysis was to examine the effect of a responsive parenting (RP) intervention designed for obesity prevention on parents' infant feeding practices in the first year after birth. Methods: Primipar...

Importance Rapid growth and elevated weight status in early childhood increase risk for later obesity, but interventions that improve growth trajectories are lacking. Objective To examine effects of a responsive parenting intervention designed to promote developmentally appropriate, prompt, and contingent responses to a child’s needs on weight out...

Background: A rapidly increasing BMI trajectory throughout childhood is associated with negative health outcomes in adulthood such as obesity, cardiovascular disease, and diabetes. The purpose of the current study was to assess whether BMI trajectories from age 5-15 predicted changes in weight and BMI from adolescence to adulthood, and dieting-rel...

Objective: Infants higher on negative reactivity and lower on regulation, aspects of temperament, have increased obesity risk. Responsive parenting (RP) has been shown to impact the expression of temperament, including the developing ability to regulate negative emotions. The aim of this analysis was to test the effects of the INSIGHT study's RP i...

Abstract Background Sedentary behaviors, including screen time, in childhood have been associated with an increased risk for overweight. Beginning in infancy, we sought to reduce screen time and television exposure and increase time spent in interactive play as one component of a responsive parenting (RP) intervention designed for obesity preventio...

Background Previous RCTs to prevent early rapid weight gain were conducted in predominantly White, well-educated, middle-income mother-infants at low risk for obesity. To inform the design of an RCT in a higher-risk sample, we conducted a short-term, longitudinal study to compare maternal feeding beliefs and behaviors, infant sleep, intake, and gro...

Gut and oral microbiome perturbations have been observed in obese adults and adolescents. Less is known about how weight gain in early childhood is influenced by gut, and particularly oral, microbiomes. Here we analyze the relationships among weight gain and gut and oral microbiomes in 226 two-year-olds who were followed during the first two years...

Background: Although widely used by infants, little is known about the long-term effects of pacifiers. We investigated relationships between pacifier use in infancy and appetite, temperament, feeding, and weight outcomes through age 2 years using data from the Intervention Nurses Start Infants Growing on Healthy Trajectories study. Methods: Moth...

Objectives: The American Academy of Pediatrics recommends infant-parent room-sharing until age 1. We assessed the association between room-sharing and sleep outcomes. Methods: The Intervention Nurses Start Infants Growing on Healthy Trajectories study is an obesity prevention trial comparing a responsive parenting intervention with a safety cont...

Objective: To determine whether a responsive parenting (RP) intervention affects infant dietary patterns. Methods: Primiparous mother-newborn dyads (n = 291) were randomized to the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) RP intervention or control. Curricula were delivered at nurse home visits at ages 3, 16, 2...

Objectives Describe themes characterizing feeding behaviors of low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and identify the attitudes, beliefs, and sources of information that inform these practices. Methods Formative research was conducted including focus groups and semi-stru...

Objectives: Inadequate sleep during infancy is associated with adverse outcomes for infants and families. We sought to improve sleep behaviors and duration through a responsive parenting (RP) intervention designed for obesity prevention. Methods: The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is a randomize...

Importance Rapid infant weight gain is associated with later obesity, but interventions to prevent rapid infant growth and reduce risk for overweight status in infancy are lacking. Objective To examine the effect of a responsive parenting (RP) intervention on infant weight gain between birth and 28 weeks and overweight status at age 1 year. Design,...

Because infants are totally dependent upon parents (or other caregivers) for care and sustenance, parents' feeding practices are a key feature of the family environments in which infants and young children learn about food and eating. Feeding practices include not only what the child is fed, but also the how, when, why and how much of feeding. Exte...

Composition of the infant diet changes rapidly throughout the first year of life, and caregiver decisions on when to introduce foods and what to feed an infant vary. Early dietary patterns have been associated with differing risk for obesity as well as food preferences and intake later in childhood. The objectives of this analysis were to 1) identi...

Background: Maternal symptoms of depression are related to suboptimal parenting practices and child well-being; women with elevated symptoms tend to be less responsive to their children. Objective: The objective is to explore how maternal depressive symptomatology is related to childhood obesity-promoting parenting behaviours, and whether depres...

There is increasing interest in leveraging social media to prevent childhood obesity, however, the evidence base for how social media currently influences related behaviors and how interventions could be developed for these platforms is lacking. This commentary calls for research on the extent to which mothers use social media to learn about child...

Objective: This study analyzed child feeding beliefs and behaviors, types of recipes, and their associations in blogs focused on child feeding. Design: The authors selected 13 blogs using purposive snowball sampling, from which 158 blog posts were sampled and coded using directed qualitative content analysis. Variables measured: Child feeding...

Sugar-sweetened beverage (SSB) intake is a substantial source of energy in the diet of US children. We examined the associations between mothers' child-feeding practices and SSB intake among 6-y-old children. We analyzed data from the Year 6 Follow-up of the Infant Feeding Practices Study II in 1350 US children aged 6 y. The outcome variable was ch...

We examined the associations between mothers' child‐feeding practices and children's sugar‐sweetened beverage (SSB) intake among 6‐year‐olds using data from the Year 6 Follow‐Up of Infant Feeding Practices Study II (n=1350). The outcome variable was child's SSB intake. The exposure variables were 4 child‐feeding practices of mothers (set limits on...

Addressing the childhood obesity epidemic continues to be a challenge. Given that once obesity develops it is likely to persist, there has been an increasing focus on prevention at earlier stages of the life course. Research to develop and implement effective prevention and intervention strategies in the first 2 years after birth has been limited....

Background: Evidence suggests an association of breastfeeding with a maternal feeding style (MFS) that is less controlling than formula feeding, which, in turn, may improve a child's self-regulation of eating. This study examines associations of bottle-feeding practices during infancy with MFS and children's eating behavior (CEB) at 6 years old....

During the first 2 y of life, development is rapid and includes dramatic changes in eating behavior. Individual patterns of food preferences and eating behaviors emerge and differ depending on the foods offered and on the contexts of feeding during this early period of dietary transition. In this review, we discuss evidence on ways in which early l...

Background: New evidence suggests that behavioral mechanisms play a role in the association between breastfeeding and childhood obesity. The purpose of this study is to examine whether milk feeding method in infancy predicts maternal feeding styles (MFS) and children's eating behavior (CEB) at 6 years old. Methods: Linking data from the Infant Feed...

Currently, about 10% of infants have a weight for length greater than the 95th percentile for their age and sex, which puts them at risk for obesity as they grow. In a pilot obesity prevention study, primiparous mothers and their newborn infants were randomly assigned to a control group or a Soothe/Sleep intervention. Previously, it has been demons...

Objective: Our objective is to evaluate the effectiveness of 4-Health, an 8-month intervention program for parents intended to reduce obesity risk in preteen children. Description: A two-group repeated measures design was used to assess the effectiveness of the 4-Health program vs. an information-only control using 21 Montana sites. Evaluation: Pre...

Background: Without effective intervention, it is predicted that 50% of children in the US will be obese by 2030. Establishing responsive feeding practices early in life may promote self-regulation, have lasting effects on eating behavior and eventually establish healthy growth and development. A promising point of intervention is preventing the us...

Evidence indicates that excessive weight gain in the first years of life can alter developing neural, metabolic and behavioral systems in ways that increase the risk for obesity and chronic disease later in life. Relative to work with other age groups, limited attempts are being made to prevent obesity during the first years of life, even though th...

Background: Large food portions are thought to contribute to child obesity by inflating consumption norms and stimulating intake. These effects are attributed to visual cues; including the size of eating implements [EI] (i.e. plate, bowls). Whether EI influences children's self-selected portion [SSP], however, is not well established. Objectives: T...

Background: Portion size influences children's energy intakes at meals, but effects on daily intake are unknown. Objective: Effects of large portions on daily energy intake were tested in 5-y-old Hispanic and African American children from low-income families. Maternal food intake data were collected to evaluate familial susceptibility to portion s...

This book uses research and theory to an in-depth account of children's understanding of biology and health. Each of the contributors views children's understanding in these areas to be to some extent adaptive to their well-being and survival and uses evidence collected through a variety of different techniques to consider whether young children ar...

Background: Obese parents are more likely to have obese children. Parents provide both the genes and eating environment for their children and familial patterns of adiposity are the result of gene-environment interactions. Environmental factors are implicated in the rapid increases in prevalence of childhood overweight that have occurred in the pas...

To obtain information on the development of the learned control of food intake, preschool children (N = 22) participated in conditioning and extinction trials to determine whether meal size could be conditioned. Each trial consisted of a two-part snack in which consumption of a fixed amount of a distinctively flavored high (145 kcal) or low (60 kca...

We undertook this investigation to provide information that would serve as the basis for designing an educational program to increase breastfeeding. Guided by the principles of the theory of reasoned action, we developed specific objectives to determine the predictive value of attitude and social influences on 1) mothers' intentions to breastfeed o...

The present study concerns the comparability of three techniques that are commonly used to assess the dependability of family observational measures: analyses of observer agreement, reliability, and generalizability. To illustrate the use of these procedures, 12 middle-SES families with preschool children were separately videotaped as they interact...

To investigate children's sharing of preferred and nonpreferred food with same-sex peers, 57 3-5-year-old children participated twice as potential sharers-once with a friend and once with an acquaintance. Food was unequally distributed, with the target child receiving 10 pieces each of preferred and nonpreferred food and the potential recipient onl...

The purpose of these two experiments was to determine (a) whether young children can be responsive to caloric density cues in regulating their food intake, (b) whether such cues can be associatively conditioned to organoleptic cues in foods, and (c) to obtain evidence regarding which of the many cues available are involved as conditioned stimuli. I...

Parents frequently employ contingencies in attempts to regulate children's food intake. To investigate the effects of instrumental eating on food preferences, each of 45 preschool children was assigned to either an instrumental eating or a control condition. In the instrumental conditions (N = 31), children consumed an initially novel beverage to o...

The psychological research discussed in this paper provides evidence that conditioning and social modeling procedures contribute to the formation and modification of the affective components of eating behavior. The presence of affective reactions to food-related chemical stimuli in neonates, prior to the opportunity for learning, suggests that some...

Preschool children (N = 23) preferences for 8 snack foods were assessed. 1 of 2 target foods from the set was selected for each child and presented consistently in a positive social context. After 20 presentations paired with positive adult attention, a significant enhancement of preference was noted. The preference data were also examined to deter...

The purpose of this study was to examine relationships between the degree of fatness in young children and mother-child interaction behaviors in an eating and non-eating situation. The 21 children in the study ranged in age from 44 to 81 months. The mother-child pairs represented a broad range of socioeconomic classes. Triceps skinfold thickness se...

The effects of several social-affective presentation contexts on the formation of preschool children's food preferences were investigated. The children's preferences for a set of snack foods were initially assessed and a neutral food, neither highly preferred nor nonpreferred, was selected for each child. This snack food was then presented to the c...

Food preferences were obtained directly from 128 preschool children and their parents, using four different sets of foods: fruits, vegetables, sandwiches, and snacks. When the rank orders of preferences given by the children were correlated with those of their parents, only 10% of the mother-child and 6% of the father-child correlations were signif...

To assess the relationship between stated preferences and consumption patterns for preschool children, measures of preference and consumption were obtained independently from 17 nursery school children during snack period on four consecutive days. Snacks were eight different kinds of small open-faced sandwiches. Children indicated their preferences...

In a series of four assessments, 37 preschool children indicated their liking for a set of fruits by rank ordering the items. Using multidimensional scaling techniques, the salient dimensions underlying the children's preferences were found to be familiarity and sweetness. Assessment II was a replication designed to determine the stability of prefe...

The purpose of this experiment was to determine whether age differences noted when two tasks are performed concurrently can be accounted for in terms of age differences in single task baseline performance. Two groups of 12 8-year-olds and one group of 12 13-year-olds performed a compensatory tracking task and an auditory matching task, first alone...