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 Babies who don’t learn to eat only when they’re hungry can have an
increased risk of obesity, and excessive weight gain during infancy
is also associated with a higher risk of chronic diseases like
diabetes and high blood pressure later in life, researchers note in
Pediatrics. Practices like too many feedings, oversize bottles, or
what’s known as bottle propping, or giving a baby a bottle by
leaning it on a pillow or support instead of holding it, can all
encourage babies to eat too much.
As of 2008, the majority of states required child care providers to
hold babies during feedings and to follow plans for giving infants
bottles, but the rules often didn’t apply to family-based child care
and few states had other infant feeding regulations, researchers
report.
By 2016, however, nearly all states had updated their regulations to
encourage feeding practices that do things like support
breastfeeding and discourage over-feeding, the study found.
“Most parents share the responsibility for feeding their infants
with another caregiver – the child care provider,” said lead study
author Sara Benjamin-Neelon of the Johns Hopkins Bloomberg School of
Public Health in Baltimore.
“In our review, we found that more states now require a feeding plan
for infants from the parent or a physician,” Benjamin-Neelon said by
email. “A feeding plan ensures that parents and providers are on the
same page about what to feed and when to feed infants in care.”
Good communication between parents and child care providers can, for
example, prevent breastfed babies from receiving a bottle right
before they’re picked up at the end of the day. If babies are hungry
when they’re picked up, it’s easier for mothers to breastfeed their
infants, Benjamin-Neelon said.
“Child care providers can help ensure that mothers and infants
continue to breastfeed successfully,” Benjamin-Neelon added. “State
regulations can help make sure that happens by guiding infant
feeding practices.”
Pediatricians recommend that mothers exclusively breastfeed infants
until they’re at least six months of age because it can reduce
babies’ risk of SIDS as well as ear and respiratory infections,
allergies, childhood obesity and diabetes.
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In addition, pediatricians advise parents to feed babies on demand
in response to crying or other hunger cues. This practice can help
parents avoid giving infants too much to eat and can encourage
babies to eat only when hungry. The advice is harder to follow at
daycare, however, when providers may struggle to have a routine for
all of the kids while feeding individual infants at different times.
For the study, researchers looked at changes over time in state
regulations covering 10 infant feeding standards at daycare centers.
These include supporting breastfeeding and having a feeding plan as
well as things like avoiding solid foods before 6 months of age and
cow’s milk before 12 months, holding babies while they eat, and not
permitting babies to carry or sleep with bottles.
Delaware was the only state with regulations meeting 9 of the 10
standards for daycare providers in 2008.
By 2016, all but one state required babies to be held during
feedings, 41 states required feeding plans, 31 states didn’t allow
babies to carry or sleep with bottles, and 25 states required
feeding on demand.
One limitation of the study is the lack of data on how rigorously
these regulations are followed or enforced, researchers note.
Even so, parents should be aware that most states have rules in
place and do their homework, said Myles Faith, a researcher at the
University at Buffalo in New York who wasn’t involved in the study.
“Many parents might not know expert feeding guidelines exist for
early care and education (ECE) settings and that facilities are
expected to be compliant,” Faith said by email.
“Parents can also ask if they or physicians can provide a feeding
plan for their own infant, which is one of the recommended
guidelines,” Faith added. “These can be empowering conversations for
caregivers making such important decisions.”
SOURCE: http://bit.ly/2hwFlmS Pediatrics, online November 1, 2017.
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