Infant self-regulation and body mass index in early childhood
Peacock-Chambers, Elizabeth Marcela
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BACKGROUND: Poor self-regulation during preschool and early school age years is associated with rapid weight gain. However, the association between self-regulatory capacities in infancy and weight status in early childhood has not been well studied. Objective: Examine prospective associations between infant self-regulation and body mass index (BMI) in early childhood. We hypothesized that infants exhibiting less optimal self-regulation would be at greater risk of obesity at 3–5 years of life. METHODS: We used data from 5750 children in the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), excluding premature infants and infants small or large for gestational age. Our primary predictor was infant self-regulation measured at age 9 months by parent completion of the Infant Toddler Symptom Checklist (ITSC). We defined child obesity at preschool and kindergarten age (approximately 4 years and 5–6 years respectively) as a body mass index (BMI) ≥ 95th percentile for age and sex by US Centers for Disease Control growth charts. We created logistic regression models comparing risk of obesity at preschool and kindergarten age in infants with ITSC scores ≥ 6 to infants with scores < 6, controlling for covariates. RESULTS: Twenty-one percent of children with ITSC scores ≥ 6 at 9 months were obese at preschool age compared to 16% of children with lower ITSC scores. At kindergarten age this difference decreased to 18% vs. 16% respectively. After adjusting for covariates, infants with ITSC scores ≥ 6 had 32% increased odds of being obese at preschool age (aOR 1.32; 95% CI: 1.03, 1.70) though this association decreased at kindergarten age (aOR 1.07; 95% CI: 0.79, 1.45). CONCLUSIONS: Poor infant self-regulation at 9 months is associated with an increased risk of obesity at preschool entry but not at kindergarten entry. Helping parents manage and respond to children’s self-regulation difficulties prior to preschool age may serve as a focal point for future interventions.