“C-Section May Boost Childhood Obesity Risk, Study Finds,” Jennifer Huget, The Washington Post, May 23, 2012.
WHAT IS CHILDHOOD OBESITY ?
“Childhood obesity is a serious medical condition that affects children and adolescents. It occurs when a child is well above the normal weight for his or her age and height,” defines the Mayo Clinic. Physical diseases such as diabetes, high blood pressure and high cholesterol used to be prevalent primarily among adults. Now, we see children with extra weight (obesity) heading down the path toward these conditions. Furthermore, children with obesity are at risk for developing poor self-esteem. Research is showing us how certain factors in infancy may contribute toward the development of this condition.
OBESITY AND C-SECTIONS
This past May, research was published in the BMJ Archives of Disease in Childhood showed babies delivered by c-section were more likely to become obese as children than babies born vaginally. In fact, they were almost twice as likely to become obese. The study looked at records of 1255 mom/baby pairs, with 274 delivered by c-section and 971 delivered vaginally. Researchers looked at both the BMI (Body Mass Index) and the skin-fold of the children at the age of three. BMI is calculated from the weight and height and is a screening tool. At the age of three, 15.7 percent of the babies delivered by c-section were obese compared with 7.5 percent of those delivered vaginally.
The authors of the study suggest that the babies delivered by c-section are not exposed to the same colonies of digestive bacteria as a baby delivered vaginally. They suggest that this lack of digestive bacteria may diminish the digestion and absorption process of food and contribute to obesity. The authors point out that 4 to 18 percent of c-sections are carried out at “maternal request” rather than at the doctor’s recommendation.
PREVENTION OF CHILDHOOD OBESITY
Once baby is born it is not possible to change the way in which she entered this world. Although we can can not change the fact that some babies were born by c-section, what we can do is minimize other contributing factors. Parents help prevent childhood obesity by feeding babies and toddlers healthy and fresh foods rather than highly processed ones and by providing daily time on a play mat, in a swimming pool, or at the park for exercise. Although a c-section can be a life-saving delivery method, elective ones may diminish with this new research. Through pre-natal education, research studies such as this one may provide important points of discussion regarding the cost/benefit of an elective c-section delivery.
“Antibiotics Too Soon May Set Babies Up For Obesity: Study,” Dr. Shari Barnett, ABC Medical News, August 21,2012.
CHILDHOOD OBESITY RESEARCH
New research suggests that giving babies antibiotics too soon in life may contribute to obesity. The study published in the International Journal of Obesity reflected research in the United Kingdom with a group of over 11,500 babies. Researchers checked the height, weight and antibiotic use of babies at birth, 7 weeks, 10 months, 20 months, 38 months and 7 years. Even though researchers took into consideration factors such as whether the mother smoked while pregnant, what the baby ate, socioeconomic factors, and the weight of the baby’s parents, a relationship between antibiotic use and weight gain was clear. Specifically, the use of antibiotics between birth and 6 months was a factor.
CHILDHOOD OBESITY: CONTRIBUTING FACTORS
The importance of this study is that it shifts our thinking about obesity from primarily a “diet and exercise” approach to include “environmental exposures.” In an ABC news story, Dr. Richard Decklebaum, professor of nutrition, pediatrics and epidemiology at Columbia University Medical Center states “I think that generally antibiotics are quick, frequently overused by practitioners to treat viral infection.” He thinks practitioners need to be aware and not overprescribe antibiotics. Other factors which research shows may contribute to obesity in childhood include working mothers and C-section deliveries. We will look at the research on these topics soon.
TIPS FOR BABIES AND PREVENTION OF OBESITY
The new study recommends checking with your doctor to verify that baby’s health condition requires antibiotics for treatment. Physicians and the media are quick to point out that this study does not mean that antibiotics should be avoided when needed. It is very important to give the baby antibiotics if a medical condition exists. Keep in mind the importance of diet and exercise factors as well. For parenting tips on prevention of obesity in young children, read our posts:
“FDA Makes It Official: BPA Can’t Be Used in Baby Bottles and Cups,” Sabrina Tavernese, New York Times, 7/17/12.
WHAT IS BISPHENOL A ?
Used since the 1960′s, Bisphenol A is an industrial compound used in making some plastics such as food containers, bottles, and cups. Usually referred to as BPA, it is also used in resins found in the linings of metal products such as food cans, baby formula cans, and in some toys. It also can be present in dental sealants and composites and may be found in the linings of water lines. According to an article on the topic on MayoClinic.com, BPA can even be identified in some thermal paper products such as cash register receipts. In recent years the effects of BPA on health has been a debated topic in the news and the subject of ongoing research. This week, the Food and Drug Administration banned the use of BPA in baby bottles and sippy cups.
REDUCING BISPHENAL A EXPOSURE
Some research studies show that BPA seeps its way into the food or beverage that is contained in a bottle or container which contains the compound. Plastics containing BPA can be identified by looking at the recycling number on the bottom of the product. Often, they are the clear containers. The BPA plastic number is the number 7. Avoid buying plastics with the number 7 on the bottom or choose a “BPA free” product.
Another concern is that BPA seeps into the body when one handles something containing the substance like a toy or cash register receipt. There has been much controversy on this topic and research studies continue. However, the National Toxicology Program at the Department of Health and Human Services expreses concern for this compound and its effect on human health. Recently, the Food and Drug Administration (FDA) banned BPA from use in the manufacturing of baby bottles and sippy cups. This makes it much easier for concerned parents to confidently choose a bottle or cup for their baby.
WHAT DOES “BPA FREE” MEAN ?
Many plastics manufacturers are making plastic containers and bottles that do not contain the BPA compound. These are often labeled “BPA Free.” Another option is to choose a material other than plastic such as glass or steel. Over the last few years, there has been a tremendous increase in the manufacturing of bottles, cups, and food storage containers made of glass or steel. There are far more “green” choices available on the market now. You can find websites online for purchasing green baby bottles or green sippy cups. “Green” means “BPA Free.” One popular website is greentogrow.com Just remember, the best baby bottles are the green baby bottles.
A DIETARY REVOLUTION
Cereal is often the first food introduced to baby. What a change this is for her! Until now she has been drinking only liquids such as milk or formula. The introduction of a solid food into baby’s diet is a revolution in her dining experience. Not only does the introduction of a solid food present a new texture and flavor, but it also presents a mechanical challenge. She now must learn how to use her tongue to move the cereal around in her mouth. She must coordinate the action of the tongue with the action on swallowing. She may even need to chew a bit which uses the action of her jaw…opening and closing. These actions work together to prepare and swallow the more solid food inside her mouth.
CHOOSE HEALTHY CEREAL FOR BABY
With all the packaged cereals available for baby today, please choose wisely. Select whole-grain baby cereals free of additives. This means free of salt, free of sugar, and free of chemical preservatives. Many vitamins are removed from the cereals when the grain is stripped, thus “whole-grain” is the more nutritious choice.
THE MECHANICS OF FEEDING CEREAL TO BABY
Introduce cereal to baby by giving her just one single teaspoonful so she can experience a new taste and a different texture. Use a small spoon when feeding her. Place the spoonful of cereal at the middle of her tongue. If you place it too close to the front of her mouth, near her lips, she may accidentally push the food out of her mouth as her tongue moves around. When she seems to successfully manage the teaspoonful of cereal over a number of days you can increase the amount to two or three tablespoonsful. Try and feed the solid food before giving her milk or formula because otherwise she may fill up with the liquid and refuse the nutritious solid food.
EATING IS A MOTOR MILESTONE
Remember that eating is one of the Stellar Caterpillar Top 10 Motor Milestones. Just like learning to roll or crawl, there are micro-skills that make up this milestone. For example, baby has to learn to move the food with her tongue before swallowing it. It takes time for her to learn and she learns well when introduced to a new skill in little steps, or should we say, in “small bites.”
BABY FOOD: HOMEMADE VS. STORE BOUGHT
When it is time to add vegetable purees into baby’s diet, the health conscious mother looks for an alternative to the store-bought baby food jars filled with added sugar and salt. One also does not know if the vegetables in the jars were exposed to harmful chemicals such as pesticide residue. The baby food sold in jars has salt added to preserve the food and often sugar is added to enhance the flavor. The healthiest choice is for mother to make baby-food at home with organic vegetables. The lower the intake of salt, sugar, and chemicals, the healthier baby will be. Recently we discussed the importance of monitoring the salt content in baby’s diet as published in the American Journal of Clinical Nutrition.
PREPARING VEGETABLE PUREES
Making your own baby food is easy to do if you have a blender or food mill and access to fresh, organic vegetables. Even if you do not have a blender or food mill, you can still make your own baby food at home. Begin by purchasing only organic vegetables. You can peel, wash, chill, grind/puree, and immediately steam the vegatables. Or, you can peel, wash, cook, and then grind/puree. Most blenders have a setting labeled “puree.” The food mill allows you to grind the food into the tiny particles which make a puree. Either tool works fine. Or, one can grate or shred the vegetables if there is no food mill or blender available. Today there are books/websites available on making your own baby food. Have fun with it!
INTRODUCING PUREES TO BABIES
Is baby not eating her vegetables? The method I recommend to mothers for introducing a new food to babies is one I learned from the great nutritionist Dr Carlton Fredericks. In his chapter “The Well-Fed Baby,” from his book Look Younger, Feel Healthier, Dr. Fredericks describes this special technique. “The most successful method is to present the new food combined with a familiar one,” he explains. “Cook it in milk at a simmering temperature of approximately 200 degrees (Farenheit) . The milk should be subsequently used for cream sauces and soups.” Over time, add in less of the familiar food. Remember to always check with your doctor to learn what foods should not be given to baby and at what temperatures food should be heated.
BENEFITS FOR BABY OF HOMEMADE BABY FOOD
- omits sugar content
- free of added salt
- eliminates pesticide/chemical residue when organic vegetables are used
- virtually no nutritional values are sacrificed
Why are teething biscuits such a popular snack for babies? They are cleverly designed to develop the skill of chewing. These small snacks resemble a cookie in shape and size, but usually are free of much sugar and spice. Ideally, they are made of simple grain ingredients and quite firm in texture. The firmness makes it difficult for baby to bite off a large piece, on which she could choke. Her jaw opens and closes as she gnaws away at the biscuit until her saliva softens it enough so a tiny piece breaks off, which she swallows easily. This action of opening and closing her jaw develops the skill of chewing. Once the tiny piece of biscuit is in inside her mouth, she will need to movie it around with her tongue to prepare it for the action of swallowing. This is the skill of chewing food: using the muscles of the jaw and mouth in a coordinated manner.
BABY EATING & THE FIVE SENSES
It is a new experience for baby to touch a piece of food, bring it to her own mouth, and experience the taste of it. Prior to introducing these finger foods she has been spoon and bottle fed. Baby is now seeing the food, touching the texture with her hands, smelling with her nose, hearing the crunch of her bite, and tasting the flavor. This is both a new coordination and sensual experience for her.
BABY EATING HABITS
As we have learned, the flavor preferences later in life which can influence health and well-being are being traced back to foods given in infancy. Thus, it is important to try and develop healthy eating habits in the first year of life. Learn to read the labels and choose organic teething biscuits when possible. Look for ones made without added sugar and salt. For babies with wheat allergies one can find arrowroot teething biscuits. Some ambitious mothers even make their own from scratch with teething biscuit recipes found on the internet. It is a good idea to check with your pediatrician before using an internet recipee. Remember, our options today are many. Choose wisely.