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

Abstract

Background: Previous studies show inconsistent relations between child care and obesity, but few assessed longitudinal associations during infancy and even fewer included racially diverse children. We examined associations of time infants spent in child care, both overall and in different types of care, with weight status at 6 and 12 months. Methods: We examined 664 infants living in central North Carolina. We conducted adjusted multivariable linear regressions examining (1) child care from birth to 6 months and 6-month weight-for-length (WFL) z-score, and (2) child care from birth to 12 months and 12-month WFL z-score. We assessed any child care and child care by type, including relative care, informal care by a nonrelative, formal child care, and a combination of care (e.g., relative and informal care). Results: Nearly 70% of infants were black and 49% were female. After adjustment for potential confounders, any child care was not associated with WFL z-score at 6 months (0.07; 95% confidence intervals [CI]-0.02 to 0.16; p = 0.13) or 12 months (0.05; 95% CI-0.02 to 0.12; p = 0.19). However, greater combination care was associated with higher WFL z-score at 6 months (0.68; 95% CI 0.23-1.13; p = 0.003) and greater care by a relative was associated with higher WFL z-score at 12 months (0.16; 95% CI 0.05-0.26; p = 0.005). Conclusions: Although we did not observe associations with any child care, combination care and relative care during infancy were associated with higher weight. Interventions aimed at preventing excessive weight gain in early life may target relatives who provide regular care for infants.

Identifying elevated child weight from 3 to 24 months: Early transitions into nonparental care and to solid foods

“…Descriptively, child WFL/WFHz was highest for those in daycare, however, children who were in kincare and experienced ITS before 6 months also demonstrated high WFL/WFHz over time, compared to parental care. These findings align with existing research demonstrating risk for elevated weight gain among infants cared for by relatives as opposed to by parents 16,30,37 . Benjamin‐Neelon and colleagues found that care by grandparents was associated with higher weight at 12 months in a sample of predominantly Black infants 37 .…”

“…These findings align with existing research demonstrating risk for elevated weight gain among infants cared for by relatives as opposed to by parents. 16,30,37 Benjamin-Neelon and colleagues found that care by grandparents was associated with higher weight at 12 months in a sample of predominantly Black infants. 37 Our data suggests that early ITS may place children at a disadvantage in terms of weight outcomes among those in kincare.…”

“…16,30,37 Benjamin-Neelon and colleagues found that care by grandparents was associated with higher weight at 12 months in a sample of predominantly Black infants. 37 Our data suggests that early ITS may place children at a disadvantage in terms of weight outcomes among those in kincare. We observed that the children in kincare who began ITS "on time" exhibited the lowest WFL/WFHz over time compared to all other care-ITS groups.…”

“…A similar study categorized NPC groups as relative care, informal care, formal care, and combinations of those types of care; infants who were received more than one type of NPC or were in relative care demonstrated higher weight. 37 In the current study, NPC groups were categorized using a data-driven approach; various types of NPC were combined to form equitable groups for analysis. Within the defined groups, there may be differences within daycare (centrebased versus in-home care) and kincare settings (relatives, friends, versus nannies), however, we lack the variability or power to detect these differences.…”

Use of Child Care Attenuates the Link Between Decreased Maternal Sleep and Increased Depressive Symptoms

“…Additional information about the NURTURE study is available elsewhere. 18,19 Briefly, we recruited women from a private prenatal clinic and a local county health department prenatal clinic. To participate in the NURTURE study, women were required to be at 20 to 36 weeks' gestation, have a singleton pregnancy with no known congenital abnormalities, be at least 18 years old, speak and read English, intend to keep their infants, and plan to live in the area for at least 12 months.…”