Effects of the Sleep SAAF responsive parenting intervention on rapid infant weight gain: A randomized clinical trial of African American families

Lavner, Justin A.; Savage, Jennifer S.; Stansfield, Brian K.; Beach, Steven R. H.; Marini, Michele; Smith, Justine A.; Sperr, Megan C.; Anderson, Tracy N.; Hernández, Erika; Moore, Amy M.; Caldwell, Alice Little; Birch, Leann L.

doi:10.1016/j.appet.2022.106080

Cited by 10 publications

(36 citation statements)

References 27 publications

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“…1 for a participant flow chart. Further details on study design and recruitment/eligibility have been published previously [ 12 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…Statistical power for the study was originally calculated for the primary outcome of between-group differences in conditional weight gain scores from 3 to 16 weeks, which is reported elsewhere [ 16 ]. Target enrollment was 300 mother-infant dyads based on the INSIGHT effect size of approximately 0.4 for infant conditional weight gain at 6 months [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

“…The RP curriculum included messaging on contingent feeding (i.e., feeding in response to infants’ hunger and satiety cues), using alternatives to food to soothe, and developmentally-appropriate feeding (i.e., delaying the introduction to solids) to promote infants’ development of self-regulation of food intake [ 14 , 15 ]. INSIGHT methods and intervention materials were tailored for African American families in Sleep SAAF (e.g., emphasis on healthy sleep during recruitment rather than an explicit focus on feeding practices and/or infant weight, implementation by African American community research associates (CRAs), a booster 8-week session, photographs of African American mothers and infants; see [ 12 ] and [ 16 ]). INSIGHT infants randomized to the RP group had slower weight gain during the first 6 months, reduced overweight at age 1 year [ 8 ], and mothers showed improved responsive feeding practices (i.e., less control-based and more structure-based feeding) compared to control mothers [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…INSIGHT infants randomized to the RP group had slower weight gain during the first 6 months, reduced overweight at age 1 year [ 8 ], and mothers showed improved responsive feeding practices (i.e., less control-based and more structure-based feeding) compared to control mothers [ 17 ]. In Sleep SAAF, RP infants were less likely to experience upward crossing of two major weight-for-age percentile lines and there were small, non-significant effects of the RP intervention on conditional weight gain [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Sleep SAAF responsive parenting intervention improves mothers’ feeding practices: a randomized controlled trial among African American mother-infant dyads

Hernández

Lavner

Moore

et al. 2022

Int J Behav Nutr Phys Act

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Background/Objective Parents shape children’s early experiences with food, influencing what is served, children’s food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers’ infant feeding practices. Methods Primiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not). Results RP mothers reported more responsive feeding (p = 0.005, partial η2 = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2–0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η2 = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η2 = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe. Conclusions Responsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls. Trial registration Sleep SAAF: A Strong African American Families Study. www.clinicaltrials.gov NCT03505203. Registered 3 April 2018.

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“…1 for a participant flow chart. Further details on study design and recruitment/eligibility have been published previously [ 12 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sleep SAAF responsive parenting intervention improves mothers’ feeding practices: a randomized controlled trial among African American mother-infant dyads

Hernández

Lavner

Moore

et al. 2022

Int J Behav Nutr Phys Act

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“…Their intervention content has usually been focused on the provision of anticipatory guidance to help families establish healthy practices around behaviours known to be associated with obesity (such as feeding, sleep and activity) on the premise that it is easier to establish healthy practices early in life, than to change less healthy practices later. Results from the limited literature to date suggest only modest success in preventing RWG during infancy 20,23,45–47 . Despite these limitations, it may still be useful to look to the interventions of these trials to identify whether some of their content could be transferable to the care of infants with RWG.…”

Section: Can Early Life Obesity Prevention Interventions Inform Care ...mentioning

confidence: 99%

The care of infants with rapid weight gain: Should we be doing more?

Fangupo

Daniels

Taylor

et al. 2022

J Paediatrics Child Health

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Rapid weight gain (RWG) during infancy is a known risk factor for later childhood obesity. It can be measured using a range of definitions across various time periods in the first 2 years of life. In recent years, some early childhood obesity prevention trials have included a focus on preventing RWG during infancy, with modest success. Overall, RWG during infancy remains common, yet little work has examined whether infants with this growth pattern should receive additional care when it is identified in health-care settings. In this viewpoint, we contend that RWG during infancy should be routinely screened for in health-care settings, and when identified, viewed as an opportunity for health-care professionals to instigate non-stigmatising discussions with families about RWG and general healthy practices for their infants. If families wish to engage, we suggest that six topics from early life obesity prevention studies (breastfeeding, formula feeding, complementary feeding, sleep, responsive parenting, and education around growth charts and monitoring) could form the foundations of conversations to help them establish and maintain healthy habits to support their infant's health and well-being and potentially lower the risk of later obesity. However, further work is needed to develop definitive guidelines in this area, and to address other gaps in the literature, such as the current lack of a standardised definition for RWG during infancy and a clear understanding of the time points over which it should be measured.

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Effects of a Responsive Parenting Intervention Among Black Families on Infant Sleep

et al. 2023

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ImportanceBlack individuals in the US experience sleep disparities beginning in infancy and continuing throughout the lifespan, suggesting early interventions are needed to improve sleep.ObjectiveTo investigate whether a responsive parenting (RP) intervention for Black mothers improves infant sleep and increases responsive sleep parenting practices.Design, Setting, and ParticipantsThis is a post hoc secondary analysis of the Sleep SAAF (Strong African American Families) study, a randomized clinical trial comparing an RP intervention with a safety control condition over the first 16 weeks post partum. Data were collected between spring 2018 and summer 2021. Families were recruited from the mother-infant nursery at Augusta University Medical Center, Augusta, Georgia, and completed home visits at 1, 3, 8, and 16 weeks post partum. Primiparous Black mother-infant dyads were screened for eligibility using medical records. Results were analyzed on an intention-to-treat model. Data were analyzed from March 2022 to January 2023.InterventionsThe RP intervention curriculum focused on infant sleep, soothing and crying, and feeding. The control group received a safety intervention. Community research associates delivered the interventions during home visits at 3 and 8 weeks post partum.Main Outcomes and MeasuresThe primary end point was infant sleep duration at 16 weeks. Mothers reported on bedtime routine and sleep behaviors, infant sleep duration, and nighttime waking and feeding at 8 and 16 weeks post partum using questionnaires.ResultsA total of 212 Black mothers (mean [SD] age, 22.7 [4.5] years) were randomized, including 208 mothers (98.6%) who identified as non-Hispanic and 3 mothers (1.4%) who identified as Hispanic; 108 mothers were randomized to the RP group and 104 mothers were randomized to the control group. At 16 weeks post partum, infants in the RP group had longer reported nighttime sleep duration (mean difference, 40 [95% CI, 3 to 77] minutes), longer total sleep duration (mean difference, 73 [95% CI, 14 to 131] minutes), fewer nighttime wakings (mean difference, −0.4 [95% CI, −0.6 to −0.1] wakings), and greater likelihood of meeting guidelines of at least 12 hours of total sleep per day (risk ratio [RR], 1.4 [95% CI, 95% CI, 1.1 to 1.8]) than controls. Relative to controls, mothers in the RP group more frequently reported engaging in some RP practices, including giving the baby a few minutes to fall back asleep on their own (RR, 1.6 [95% CI, 1.0 to 2.6]) and being less likely to feed their baby as the last activity before bed (RR, 0.5 [95% CI, 0.3 to 0.8]).Conclusions and RelevanceThis secondary analysis of a randomized clinical trial found that an RP intervention for Black families improved infant sleep and increased some responsive sleep parenting practices.Trial RegistrationClinicalTrials.gov Identifier: NCT03505203

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Effects of the Sleep SAAF responsive parenting intervention on rapid infant weight gain: A randomized clinical trial of African American families

Cited by 10 publications

References 27 publications

Sleep SAAF responsive parenting intervention improves mothers’ feeding practices: a randomized controlled trial among African American mother-infant dyads

Sleep SAAF responsive parenting intervention improves mothers’ feeding practices: a randomized controlled trial among African American mother-infant dyads

The care of infants with rapid weight gain: Should we be doing more?

Effects of a Responsive Parenting Intervention Among Black Families on Infant Sleep

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