Fat Babies

Our featured guest blogger today is Taylor Livingston, a doctoral candidate in the Department of Anthropology at UNC-CH. Taylor’s dissertation project examines whether, how and why African-American women choose to breastfeed. She is particularly interested in the ways that public health discourses and the legacy of slavery and racism in the South shape African-American women’s infant caregiving decisions and practices.

On Thursday afternoon, Dr. Margaret (Peggy) Bentley kicked off IAAR’s Spring semester talks. Dr. Bentley discussed the importance of maternal beliefs and perceptions for understanding infant feeding practices. Dr. Bentley presented the findings from the “Infant Care” study conducted with her colleagues, Dr. Amanda Thompson, Dr. Heather Wasser, and Ms. Kenitra Williams. “Infant Care,” a longitudinal study from 2003-2010, is a descriptive project undertaken with African-American first-time mothers in North Carolina to understand infant feeding. The main focus of the study was to assess if there is a connection between early infant feeding practices and childhood obesity.

It’s hard not to think about fat on a daily basis with rising public health concerns and media coverage of elevated weight and obesity in America, especially among young children, as evidenced by First Lady Michelle Obama’s “Let’s Move” campaign, and even “Saturday Night Live’s” sketch from 2010 on “Baby Spanx”—for parents who are concerned their child is “too much to love.” This concern with overweight babies was reflected in the “Infant Care” study findings. Many mothers, who were low-income African American women, noted that they were concerned about how much their infants ate, and their size. As one mother stated:

“I remember I read his medical records […] He was only about nine or ten months and it said that a robust, black male, infant and I was like ‘robust?’ you know. He was chunky but I didn’t feel like he was overweight. […] I felt like he was just healthy.”

This mother’s comments reflect another study finding: that most mothers perceive their infants to be “healthy” or normal-sized babies, when according to pediatric growth charts, the children are overweight.

There is a lot of cause for confusion. Part of the trouble lies with pediatric growth charts. Until 2012, the American Pediatric Association (APA) recommended pediatricians use the Center for Disease Control’s (CDC) growth charts. Now, pediatricians are supposed to use the World Health Organization (WHO) growth charts. The problem? Your child can be considered overweight on one, and not on the other. The CDC charts are based on US formula-fed babies’ growth. WHO charts are based on world average growth patterns of breast milk-fed babies. Further compounding this confusion is a lack of information on infant daily intake values (how many calories babies need), and what types of foods, and how much babies should be eating. The APA’s regulations for complementary feeding (foods introduced to infants after 6 months of age while still breast milk or formula feeding) are vague at best: “Introduce solid foods around 6 months of age. Expose baby to a wide variety of healthy foods. Also offer a variety of textures.”

But, what is a “healthy food”? A wide variety? And how much? Dr. Bentley’s new study, “Mothers and Others,” an intervention preventing childhood obesity in African-American families, aims to help mothers and other caregivers alleviate their concerns about infant feeding by providing caregivers with specific information on the timing, type, and amount of complementary foods. Dr. Bentley and her team hope other researchers follow suit, so clearer recommendations for infant complementary feeding become available.