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I'm a pediatrician by training with an undergrad degree in journalism. I spend my days teaching and mentoring future pediatricians. My wife and I spend our evenings and weekends keeping up with very active twins. This blog will chronicle my thoughts on current children's health care issues and trends, trials and tribulations as a parent and husband mixed in with a lot of life experience.

 

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photo William Stratbucker, MD
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Sunday, November 14, 2010
Obesity Prevention Starts Before Birth
by William Stratbucker, MD at 05:06 PM

You might be saying "my child is too young to have to worry about obesity." Please, read on. Many parents will soon bring their infant to the doctor only to discover that a healthy baby is not one that is overweight. As many of you know we launched the Helen DeVos Children's Hospital Healthy Weight Center in April and we are off and running (literally) with five to17 year-old patients working on reducing their body mass index (BMI) and increasing the understanding of healthy nutrition and activity among the patients and their parents. The excitement of our center is only tempered by the extent of the problem of childhood obesity in our community. Children in West Michigan are not necessarily more at risk than children elsewhere. Every child is at risk in today's society.

We know that not every child who has a problem with weight or even all children who have already developed a consequence, like high blood pressure or school bullying, will be able to be seen at our center, so we are working hard to get the messages out to all others who can play a role in reversing this epidemic and in prevention.

Parents certainly play an incredibly important role in preventing obesity and responding to the concern of a health care provider when weight becomes an issue. There are many things that we know and are learning more about every day when it comes to obesity prevention. Several that apply to children age two and older are represented by our7 6 5 4 3 2 1 message. But, for newly pregnant mothers, infants and toddlers up to age two, we know several things that can help as well.

Here are the basics, mostly in chronologic order:

1. Prenatal care is very important. Starting at conception, children develop risk factors for becoming obese. The health status of the mother, including pre-pregnancy weight, smoking status, nutrition during pregnancy, appropriate pregnancy weight gain, managing gestational diabetes and developing a plan to breastfeed are all considerations related to obesity prevention before the baby is even born.

2. Breastfeeding an infant is important for so many reasons but it may be one of the best ways to prevent obesity. Babies get great nutrition from breast milk but they also learn how to eat and how much to eat. It seems there are many elements in play including the ease at which bottle-fed babies can be overfed to the availability of breast milk compared to formula that are behind this effect. Regardless, prospective parents need to strongly consider breastfeeding if possible.

3. Post-partum support is also very important. New parents should visit with the infant's medical home physician by the fifth day of life to start establishing healthy behaviors. There, resources can be made available on post-partum depression and healthy adjustment to providing for a new member of the household and lactation support. All mothers should attend their follow-up appointments with their OB.

4. Health supervision in the doctor's office over the first two years can be a source of education for the family and observation of the growing infant/toddler to detect early signs of excessive weight gain. Many healthy habits need to start in the first two years of life that impact obesity risk and these should be the main focus of the infant's health supervision visits during this time. Parents should not only write down the baby's weight and length into the baby book, but also the weight-to-length percentile. This is a form of the BMI (used after age 2) to detect too-rapid weight gain.

5. Don't smoke. Prenatal smoking and smoke exposure in the first two years of life are both risk factors for obesity independent of other factors. The explanation of the link is elusive but this highlights the importance of assisting newly pregnant moms who smoke with quitting as soon as the pregnancy test is positive.

It is never too early to think about how to prevent obesity in your family. For more information about childhood obesity and resources for your family, visit the Healthy Weight Center portion of our Web site.

If you have specific questions about your child's health, risk for obesity or if you feel your child is overweight, call your child's doctor's office. Detection and treatment of obesity starts with your child's doctor.

Have you discovered any ways that helped you get off to a great start with your infant? Have you taken any steps to actively prevent obesity within your family? If you've been alerted that your baby is overweight, what were you told and what did you do?

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