Results at 24 months
Li Ming Wen, Louise Baur, Judy Simpson, Chris Rissel, Karen Wardle, and Vicki Flood, Effectiveness of a home-based early intervention on children’s BMI at age two years: randomised controlled trial. BMJ 2012;344:e3732. http://www.bmj.com/content/344/bmj.e3732
Objectives: To assess the effectiveness of a home-based early intervention on children’s BMI at age two.
Design: Randomised controlled trial
Setting: The Healthy Beginnings Trial was conducted in socially and economically disadvantaged areas of Sydney, Australia during 2007-2010.
Participants: A total of 667 first-time mothers and their infants.
Intervention: The intervention consisted of eight home visits from specially trained community nurses delivering a staged home-based intervention, one in the antenatal period, and seven at 1, 3, 5, 9, 12, 18 and 24 months after birth. Timing of the visits was designed to coincide with early childhood developmental milestones.
Main outcome measures: The primary outcome was children’s BMI (the healthy BMI ranges for children aged 2 years are 14.12 to 18.41 for boys and 13.90 to 18.02 for girls). Secondary outcomes included infant feeding practices and TV viewing time when children were two years of age, according to a modified research protocol. The data collectors and data entry staff were blinded to treatment allocation, but the participating mothers were not blinded.
Results: Four hundred and ninety seven mothers and their children (75%) completed the trial. An intention-to-treat analysis using all 667 participants recruited, and multiple imputation of BMI for the 170 lost to follow-up and the 14 missing, showed that mean BMI was significantly lower in the intervention group (16.53 kg/m2) than the control group (16.82 kg/m2), with a difference of 0.29 (95% confidence interval [CI] -0.55 to -0.02, P=0.04).
Conclusions: The home-based early intervention delivered by trained community nurses was effective in reducing mean BMI for children at age 2 years.
Results at 12 months
Wen LM, Baur LA, Simpson JM, Rissel C, Flood VM. Effectiveness of an early intervention on infant feeding practices and “tummy time”: randomised controlled trial. Arch Pediatr Adolesc Med. 2011;165(8):701-707
Objective: To assess the effectiveness of a home-based early intervention on infant feeding practices and “tummy time” for infants in the first year of life.
Design: Randomized controlled trial with follow-up measures scheduled at 6 and 12 months.
Setting: Socially and economically disadvantaged areas of Sydney, Australia.
Participants: We recruited 667 first-time mothers and their infants in 2007 and 2008.
Interventions: The intervention consisted of 5 or 6 home visits from a specially trained research nurse delivering a staged home-based intervention in the antenatal period and at 1, 3, 5, 9, and 12 months.
Main Outcome Measure: Changes in infant feeding practices and “tummy time.”
Results: The intervention group had a significantly higher median duration of breastfeeding at 12 months than the control group (17 weeks [95% confidence interval, 13.9-20.4 weeks] vs 13 weeks [95% confidence interval, 10.1-15.0 weeks];P=.03). Compared with the control group, the hazard ratio for stopping breastfeeding in the intervention group was 0.82 (95% confidence interval, 0.68-0.99). The intervention also resulted in a significantly later introduction of solid foods (P_.001 for trend), reducing the proportion of mothers who introduced solids before 6 months by 12% (95% confidence interval, 4%-20%) from 74% to 62%. The intervention also decreased the age at which infants started tummy time (P=.03 for trend) and increased the daily practice of tummy time by 7% from 76% to 83% (P=.05).
Conclusion: The home-based early intervention delivered by trained community nurses significantly improved some infant feeding practices and resulted in earlier daily practice of tummy time.
Trial Registration: anzctr.org.au Identifier: ACTRNO12607000168459
Arch Pediatr Adolesc Med. 2011;165(8):701-707