‘Ripple’ effect on infant zBMI trajectory of an internet-based weight loss program for low-income postpartum women

Abstract

Background: Weight loss interventions can have positive ‘ripple’ effects on untreated partners in the home, but ripple effects on infants are unknown. Objective: To examine whether a 12-month internet-based weight loss intervention for postpartum mothers had a positive ripple effect on participants' infants. Methods: A 12-month cluster randomized, assessor-blind, clinical trial enrolling 371 postpartum women at 12 Women, Infants, Children clinics in CA. Clinics were randomized to standard Women, Infants, Children or an internet-based weight loss intervention for mothers. Results: A total of 333 of the 371 (89.8%) mothers assented for infant participation. Infants were 5.3 ± 3.2 months; 75.9% were Hispanic and 64% were breastfeeding. Infant retention was 272/333 (82.7%) at 6 months post enrollment and 251/333 (75.3%) at 12 months post enrollment. In intent-to-treat analysis, a significant interaction between group and time was observed (p = 0.008) with the offspring of intervention mothers exhibiting lower zBMI change from study entry through 6 months (0.23 [CI, 0.03, 0.44] vs. 0.65 [0.50, 0.79] zBMI change, respectively; p = 0.001) but was not significant through 12 months (p = 0.16). Regardless of group, maternal reports at the final assessment indicated that infants (aged =17.2 ± 3.4 months) consumed sweetened beverages (0.93 ± 1.5/week), juice (2.0 ± 1.4/day), ‘junk food’ (7.8 ± 5.4/week) and fast food (2/month), and 46.7% of the infants had a TV in their bedroom. Conclusions: An internet-based weight loss program for low-income, postpartum mothers had a positive ‘ripple’ effect on the zBMI of infants in the home during the first 6 months of treatment.