We all know breastfeeding is the best form of nourishment you can give your baby, so before you shoot the messenger, know that I am in no way belittling breastfeeding. I fought to breastfeed my little girl, so I am 100% all for it. The American Academy of Pediatrics (AAP) urges mothers to breastfeed up until one year of age, classifying it as the most ideal (natural) nutrition for a baby. Therefore, breastfeeding and breastmilk isn’t the source of the problem, it’s us (I’m devastated to admit as I am first in this line). We (moms) must know the facts of pediatric obesity and how we contribute to its risk factors beginning as early as conception!
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KEY TAKEAWAYS (to reducing the risk of pediatric obesity)
- Try to be healthy before getting pregnant.
- Stay healthy during pregnancy by watching your weight, maintaining healthy eating habits and exercising.
- If you are overweight/obese entering pregnancy, make sure to keep up with your prenatal appointments in order to reduce your’s and your baby’s risks by monitoring growth and development.
- If you are breastfeeding (or pumping breastmilk), avoid consuming a lot of sugary foods and drinks as fructose can pass through breastmilk and has been positively associated with baby body composition.
- If you are bottle-feeding, consider using smaller bottles, to avoid overfeeding, and the paced-bottle feeding technique, which imitates breastfeeding and also ensures your baby isn’t overfed.
- If you are formula feeding, avoid formula that has added sugars or sweeteners and is high in protein (or more than 1.8 g/100 kcal).
- Introduce healthy solids when your baby is 6 months (or when your baby is both ready and approved to eat) while avoiding giving sugary drinks and juices and salty, processed and high-fat snacks and foods.
Obesity has been on the rise and a lot goes into what actually puts anyone at risk. Although genes are an important factor, nurture is no less of an important facet of obesity. You as a mom have an enormous influence on whether or not your baby will be at risk for obesity later on in its life (or even sooner). So, here is what you can do about it!
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Be Healthy Before Conceiving –
I understand that this might be news a little too late, considering you’re probably a momma already, but understanding your baby’s risk factor already gives you as a parent a huge advantage!
We, women, struggle with weight loss, so shoving the health implications of being overweight into our faces is extremely frustrating, I know. That’s why I’m not here to shame being overweight because losing weight is NOT easy, especially after having children. However, it is equally important to understand that being at an unhealthy weight does affect our babies, especially if we are overweight before pregnancy. Here are just a few implications of prepregnancy obesity:
- Can Contribute to Infertility –
Although not very common, polycystic ovary syndrome, or PCOS, is a condition in women of reproductive age that causes hormonal abnormality. To put it simply, it causes your body to produce more androgens (or male sex hormones, although women do have androgen production, it is not as significant as in males) and altered gonadotropin secretion (a big word that refers to the hormone that regulates the activity of your lady parts). The effect of these causes irregular periods and infertility (1).
- Has Extreme Complications for Both Mother and Baby –
Research has shown that moms who were obese before pregnancy had very severe complications during their pregnancies that included gestational diabetes (pregnancy specific diabetes), preeclampsia (high blood pressure during pregnancy), and even unexplained stillbirths (2). Babies of overweight mothers were also prone to many congenital (present since birth) malformations, mainly heart defects (3).
- Affects Baby’s Likelihood of Being Overweight in the Future –
It has been widely circulated, and studies have confirmed, that being overweight before pregnancy contributes to gaining more weight after pregnancy. However, in a recent study, pre-pregnancy obesity has been linked to having larger and heavier babies (4). Thus establishing potential risk factors for weight issues in baby’s future.
However, all hope is not lost if you got pregnant before losing the weight! According to the American College of Obstetrics and Gynecology (ACOG), a mother who is obese can still have a healthy pregnancy and baby if she dedicates herself to being healthy throughout her pregnancy (5).
Be Healthy Throughout Your Pregnancy –
Every mother wants the very best for her baby, and a struggle with weight should not override that desire! If you weren’t able to lose the weight before conceiving your growing bundle, you can start now (if you are pregnant, that is) and not only ensure your baby’s health but your own along the way! If you were at a healthy weight when you became pregnant then staying healthy is still essential as these are the early stages of your baby’s life and your choices have direct implications on their life. So, here’s what you can do as a mother to make sure that you have a healthy pregnancy (courtesy of the American College of Obstetrics and Gynecology):
Watch Your Weight Gain –
“Eating for Two” or “You’ll Lose it All Anyways” are myths that often circulate pregnant circles and it is important to understand that it doesn’t matter if so and so ate for two and lost all their weight because YOUR body is different (speaking from experience). The recommended weight gain during pregnancy according to the American Pregnancy Association (APA) is 28-40 pounds for women who are underweight (or BMI less than 18.5), 25-35 pounds for women who are of normal weight (or BMI between 18.5 and 24.9), 15-25 pounds for women who are overweight (or BMI between 25 and 29.9), and 11-20 pounds for women who are obese (or BMI greater than 30) (6). Studies have shown that excessive weight gain during pregnancy is strongly associated with childhood obesity, regardless of mother’s initial weight, which is why it is essential to keep track of your weight gain (7)(8).
You can check your own BMI here to see where you’re standing.
- Maintain Healthy Eating Habits –
The eating habits you establish during your pregnancy are the same ones that you’ll either appreciate or fight against after your pregnancy, so better choose wisely because it’s easier to make a habit than to break a one (especially a bad one)! The American College of Obstetrics and Gynecology (ACOG) recommends meal planning in accordance with trimester-specific calorie recommendations for pregnant women who are overweight, however, this should not be overlooked by pregnant women of normal weight as pregnancy tends to turn into an excuse to over-indulge without a second thought (5).
The ACOG recommends an intake of an extra 300 calories during the second and thirds trimesters (usually no extra calories are needed during the first trimester), however, this would be something you would have to talk with your own doctor about in relation to your specific pregnancy (5). As a note, make sure you understand what 300 calories actually looks like because I often found myself underestimating the foods I chose to eat to fit that extra criterion. Healthy eating will not only help you in a long run but also give your baby the right nutrition needed for optimal growth (and your good eating habits will likely carry on with your child as they further grow and develop).
- Exercise –
It has been recommended more and more that women exercise during pregnancy, especially since obesity during pregnancy has been on the rise. As with healthy eating, exercise can also carry over to your child and encourage daily activity once they get older and prevent the development of pediatric obesity.
Some recommendations the ACOG gives are at least an average of 30 minutes of low-intensity exercise (things like walking or swimming) a day, however, make sure you get the OK first from your own doctor (5).
- Keep Up with Regular Prenatal Care(especially if you are overweight entering into your pregnancy) –
Monitoring the progression of your pregnancy gives you more awareness in regards to the things you must do to ensure both the health of you and your baby. Obesity prevention is essential in these early stages as your baby’s growth and development is constantly monitored to ensure optimal health.
If you are overweight/obese, you most likely will be classified as a high-risk pregnancy and special precautions will be taken throughout your pregnancy up until your delivery. Moms that are obese tend to have longer labors with higher complications and are more likely to have a cesarean section (C-section) (5). Having a baby that is overweight will also prompt a C-section.
Breastfeeding vs Bottle-Feeding (Breastmilk vs Formula) –
After your baby is born, the food they consume and how it is consumed are the main factors of whether or not they will be at risk for childhood obesity. This is where the breastfeeding vs bottle feeding debates usually occur (not mentioning the debate between bottle feeding breastmilk or formula). I’m not here to tell you how you should feed your child or not, you’re the momma. You know what is best for you and your baby, as every mom’s situation is different (breastfeeding is tough!). At the end of the day, the most important thing is that baby is fed!
However, with that said, both the American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend exclusive breastfeeding for at least the first year and up to two years (or beyond) of a child’s life as optimal for development and health (9). Additionally, according to the WHO there is mounting evidence that breastfeeding does, in fact, reduce the chances of an infant developing obesity (10). There is no argument in that. Take note, though, I said “reduce” and not “prevent”. A breastfed baby can still be obese and a formula-fed baby can still maintain a healthy weight. You as a mother, do have a significant influence of which is true in the case of your own child. So, here is what you need to know, depending on if you are breastfeeding or bottle-feeding.
- If You Exclusively Breastfeed
♦ Breastfeed for at Least 6 Months to a Year.
Breastfeeding is by far the best way to reduce your baby’s risk for obesity later in life. Breastfed babies have much more regulated feedings as they control their intake by actively sucking as opposed to unregulated bottle feeding where sometimes milk flows with little effort, therefore, they are less likely to overeat. The other aspect of breastmilk feeding regulation is that there are certain hormones and like biological factors found in it that help baby moderate food energy intake, balance, and storage, establishing habits that prevent excess weight gain and obesity in the future.
Additionally, exclusively breastfed babies are more likely to have the introduction of solids postponed to 6 months of age which also curbs the potential for unhealthy weight gain (10).
♦ Avoid Consuming Secondhand Sugars.(*The interesting part)
It is known by mothers that certain things can pass through breast milk, but the degree of this knowledge is limited. What is less known is that fructose, a sugar with associations to obesity, can actually pass from the mother to the baby through breastmilk. According to lead researcher Michael Goran, when the breastfeeding mother consumes a diet high in sugar or artificial sweeteners, fructose from those foods and drinks (referred to as secondhand sugars) pass to baby and not only “create a lifelong risk for obesity, diabetes, fatty liver disease and heart disease”, but could also have negative implications on the child’s cognitive development and learning if exposure to these sugars occurs during the critical time of growth and development (11)(12).
- If You Pump Breastmilk and Bottlefeed
♦ Avoid Consuming Secondhand Sugars.
Just as with breastfeeding (look above), you want to make sure that you’re only reaping the benefits of breastmilk against the risk of obesity (among others) and avoiding consuming foods that contain a lot of sugar or artificial sweeteners. Things to avoid include juices, sodas, frappuccinos, processed foods, and sweets.
♦ Smaller Bottle Size Along with Paced Bottle Feeding.
One of the risk factors for obesity when bottle feeding is overeating. A study found that babies that were fed from larger sized bottles (over 6 ounces), tended to gain much more weight and at a much quicker pace than exclusively breastfed babies. Going with a smaller sized bottle not only discourages overeating for the baby, but it also discourages overfeeding, from the side of the caregiver, as a common practice is to try to ’empty the bottle’ (13).
Additionally, researchers found that paced bottle feeding, a form of feeding that is meant to resemble breastfeeding as much as possible, also prevented overfeeding as baby regulates the entire feeding process.
How it works is that…
1. You prop your baby up during the feeding. My husband (you will preferably want someone else to bottle feed if you are breastfeeding to prevent nipple confusion or preference towards a bottle, or in general, if you’re trying to get baby to take a bottle) usually sits up our baby between his knees with back support on the knee opposite from bottle and holding baby’s neck.
2. You want to position the bottle horizontally and touch the top of baby’s lip to stimulate the rooting reflex, just as your baby would do during breastfeeding.
3. Once baby takes the bottle, this is where the horizontal hold comes into play as you want to make sure that there is enough milk so that baby is actually working to suck it out instead of chugging it.
4. After about 20-30 seconds you will want to “take a break”, imitating the end of a letdown, and check if your baby is still hungry by lowering the bottle, still keeping the nipple in baby’s mouth.
5. If your baby continues sucking, repeat steps 3 to 4, if baby stops then the feed is over.
The benefits of paced bottle feeding go beyond preventing overeating/overfeeding. Paced bottle feeding also prevents colic and gas as your baby is fed upright reducing the amount of swallowed air, and this positioning also prevents tooth decay as milk isn’t just resting in baby’s mouth as it would be after a feed if your baby was positioned more laying down (14).
- If You Formula Feed
♦ Smaller Bottle Size Along with Paced Bottle Feeding.
Just as with bottle feeding breastmilk (look above), you still want to use a smaller bottle size (less than 6 ounces) and imitate feeding at the breast when feeding formula as it reduces chances of overeating/overfeeding among other benefits.
♦ Avoid Formula High in Sugar and Protein.
Although breast milk is the preferred nutrition when it comes to feeding baby, it isn’t always a possibility, for whatever circumstances. Yet, your baby still needs to be fed. This is where choosing formula does have an impact on your baby’s future health and weight gain.
As with breastmilk, it is best to avoid formulas with a lot of added sugars as they not only influence excessive weight gain but inhibit cognitive development and wellness (12).
Additionally, another study suggested that it is equally important to pay attention to levels of protein in baby’s formula as they found that the consumption of formula that contained lower rates of protein (less than 1.8 g/100 kcal) and amino acids that most resembled breastmilk resulted in healthier weight gain in infants. On the other hand, the consumption of formula high in protein resulted in increased weight gain and obesity risk (15).
When and what you introduce to your baby when it comes to solids is just as important to baby’s health outcomes as what you feed baby initially. So, here are some ways you could ensure that baby has the healthiest start to what will be food for baby from then on:
- Wait Until 6 Months Before Introducing Solids –
Both the AAP and the WHO recommend waiting until 6 months before introducing solids to an exclusively breastfed baby (9). This time frame is also recommended if you’re formula feeding as studies have shown that one of the biggest reasons formula fed babies tend to be overweight is because they are introduced to solids much earlier than breastfed babies (16). However, if your baby is ready and you have gotten the ok from your pediatrician, introducing solids a little earlier isn’t absolutely harmful if you follow through with the next pointers. The biggest reasons why introducing solids was associated with excessive weight gain was the consequence of unhealthy overfeeding.
As a side note, a recent study found that introducing solids earlier actually helps some babies sleep longer through the night (17)! Albeit only 16.6 minutes, but it’s still something!
- Avoid Unhealthy Foods
Once baby has been introduced to solids, the solids on baby’s menu are also very important to baby’s health and prevention against obesity. Things like sugary drinks and empty calorie foods can seem tempting to introduce as they’re usually easiest to offer and well accepted by young children, however, they have been linked directly to the rise in pediatric obesity rates and should be completely avoided. You as a parent have the power to instill good eating habits into your child, so start them young and introduce them to the large array of delicious veggie, fruit and meat combinations and opt for either breastmilk/formula or water instead of those sugary drinks.
Don’t know where to start? I have got a board for baby food already going on Pinterest if you’re interested!
Overall, the biggest takeaway of this entire post is that you as a parent could have a lot more influence over your child’s risk for obesity than even genetics (although those play their own important role). You have the power to keep your children healthy and protected by not only instilling healthy habits into your own life and modeling them to your babies, but also by implementing those healthy habits early on in their lives as well. It’s tough, but it is so worth it in the long run. Your family will thank you for it!
As always, you can find more weekly, until then!