Childhood obesity is recognised as a major public health issue worldwide. Within the UK, 20% of children starting school are already overweight or obese1. By the time they leave primary school, this increases to 30%1 and these children are likely to remain obese into adulthood, with an elevated risk of developing heart disease, diabetes and some types of cancer. They may also develop psychological problems, as a result of low self-esteem and bullying at school3.
Inappropriate dietary intake and eating behaviours that are established in infancy and during weaning, are known to persist into the second year of life4 and beyond5.
We can make a real difference to children’s futures if we start encouraging good nutrition from a very early age. Good habits that are established and ingrained when children are young are more likely to be maintained throughout life.
However, there is much confusion and conflicting advice about what and how much children should and should not be eating, that parents often struggle to make the right choices. Also a lack of time, money and sometimes limited knowledge about the principles of healthy eating including using food and sweet drinks to reward, treat or comfort their children, inadequate cooking skills to prepare food from scratch, reliance on convenience foods which are often higher in energy, fat, sugar and salt, and unhelpful food labelling and food marketing strategies that promote less healthy options has led to many parents not feeling capable or confident to feed their children correctly.
The following guidance provides current thinking on establishing healthy eating habits in early life for obesity prevention7:
Breastfeeding should be promoted through appropriate and timely support for mothers in order to initiate and maintain exclusive breastfeeding for at least 6 months. In reality, many mothers opt to bottlefeed their infant around 6 weeks of age. Bottle fed infants, consume more energy and gain more weight than breastfed infants which may be due to the mother having more control over the quantity of milk that the infant drinks than that of a breastfed infant. One of the key messages for early obesity prevention is for parents to understand that babies are born with an excellent appetite regulation mechanism – babies know when they have consumed sufficient energy for their needs. Parents should avoid overfeeding by not encouraging their baby to finish every bottle but allow him/her to stop feeding when they signal they have had enough. Weaning should be delayed to around 6 months but not be started before 4 months. Vegetables and fruit should be offered as first foods and parents should not confuse initial reactions of their baby spitting out food as dislike. They are merely learning to eat however some foods may need to be offered 10-12 times before a baby will accept the new food or flavour.
During the toddler years, parents should maintain responsive feeding by allowing toddlers to stop eating when they indicate they have eaten enough and not pressurise children to eat more or finish everything on their plate. Toddlers need less food and therefore appropriate sized portions should be offered as suggested by The Infant Toddler Forum website https://www.infantandtoddlerforum.org/portion-sizes-table-2015. Eating occasions should be limited to three meals and two snacks as a way of controlling excessive energy intake and food should not be offered to comfort or control behaviour. Meals and snacks should be limited in foods high in fat and sugar and sugary drinks but not avoiding them as this will result in making these items more desirable.
Finally, as children learn from others, aspire for family meal times that are relaxed, enjoyable and without distractions of a TV, where parents decide what is eaten and children decide how much is eaten.
- Health and Social Care Information Centre. National Child Measurement Programme – England, 2014-15 report. Available at:https://www.hscic.gov.uk/ catalogue/PUB19109
- Department of Health (2009) Healthy Weight, Healthy Lives: One Year On. http://webarchive.nationalarchives.gov.uk/20100407220245/
- Public Health England. About Obesity. Child Obesity. Health Risks. Available at: https://www.noo.org.uk/ NOO_about_obesity/child_obesity/Health_risks
- Sahota, P, Gatenby, LA, Greenwood, DC et al. (3 more authors) (2016) Ethnic differences
in dietary intake at age 12 and 18 months: the born in Bradford 1000 Study. Public Health Nutrition, 19 (1). pp. 114-122. ISSN 1368-9800
- Birch L, Savage JS & Ventura A (2007) Influences on the development of children’s eating behaviours: from infancy to adolescence. Can J Diet Pract Res 68, 1–56.
- Barker DJP (2007) Obesity and early life. Obes Rev 8, Supp. 1,45–49
- Infant Toddler Forum: https://www.infantandtoddlerforum.org/media/upload/pdf-downloads/3.3_Overweight_and_Obesity.pdf
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