Childcare in Infancy and Later Obesity: a Narrative Review of Longitudinal Studies

Abstract

Purpose of ReviewThe purpose of this review was to summarize the current literature on the longitudinal relationship between non-parental childcare during infancy and later obesity.Recent FindingsEleven studies met the inclusion criteria, comprising 74 associations relevant to the review. Studies were highly heterogeneous in terms of defining childcare, categorizing different types of childcare, assessing obesity, and age at measurement of outcome and exposure. Most of the associations were either non-significant (42 associations, 57%) or showed a significant association between increased exposure to childcare and greater obesity (30 associations, 41%). There were very few examples of associations indicating that childcare was associated with lower obesity.SummaryThere is limited research on the longitudinal relationship between childcare in infancy and later obesity. Existing studies showed mixed results, similar to recent reviews reporting on cross-sectional studies and older ages. The different definitions of childcare and wide variety of measures of exposure make comparisons between studies challenging.

Early Child Care and Weight Status in a Cohort of Predominantly Black Infants in the Southeastern United States

“…Additionally, infants who spent time in multiple types of care contributed to each exposure. We adjusted for covariates that were of a priori interest based on prior literature, 7 including infant age, gender, race, birth weight for gestational age z-score, breastfeeding duration, and early introduction of solid foods (before 4 months of age); maternal age, education, marital status, and prepregnancy BMI; and household income. We report adjusted estimates per each additional 10 hours of care each week.…”

“…3,4 Child care has been inconsistently associated with obesity in children younger than 6 years. [5][6][7][8] Among infants, previous studies have also found mixed results. [9][10][11][12][13][14][15][16][17][18] In our prior review of 11 articles examining child care during infancy and later obesity, we found that studies were heterogeneous in defining child care, categorizing child care, and measuring both exposure and outcome.…”

“…[9][10][11][12][13][14][15][16][17][18] In our prior review of 11 articles examining child care during infancy and later obesity, we found that studies were heterogeneous in defining child care, categorizing child care, and measuring both exposure and outcome. 7 A slight majority of studies found no association between child care and obesity. Some, however, observed a positive association in that greater child care in infancy was associated with higher rates of obesity later in childhood.…”

“…Some, however, observed a positive association in that greater child care in infancy was associated with higher rates of obesity later in childhood. 7 Despite this, most prior studies have been conducted in cohorts of relatively high socioeconomic status families and mainly white infants, whose rates of overweight and obesity have either plateaued or declined in recent years. 19 These signs of improvement are relatively absent for racial and ethnic minority groups, where even very young children are disproportionately burdened by obesity.…”

Associations of childcare type, age at start, and intensity with body mass index trajectories from 10 to 42 years of age in the 1970 British Cohort Study

“…Namely because healthy behaviours and obesogenic trajectories are established early in life (3,(6)(7)(8)(9)(10)(11)(12)(13) and a rising number of children attend out-of-home childcare, with many starting as early as the first year of life and spending much of their week days in these settings. (14)(15)(16) Two recent reviews have summarised the literature on the association between exposure to childcare, one between ages 0-2 years (17) and one between ages 0-5 years, (18) and obesity risk. Both these publications found that available evidence is limited to cross-sectional and short-term follow-up studies, with most studies either revealing no association or a harmful effect.…”