Obesity prevention in early life: The role and practice of Maternal and Child Health Nurses in Victoria, Australia.

Author: 
Laws R, Campbell K, Russell G, Ball K, Crawford D, Lynch J, Taylor R, Denney-Wilson E
Publication type: 
Conference presentation
Program: 
Stream 1 Families with young children
Year: 
2014

5th International Conference on Maternal and Infant Nutrition and Nurture: Relational, Bio-cultural and Spatial Perspectives, November 2014, Sydney.

This presentation is available here.

Background

Childhood overweight and obesity remains a significant public health challenge[1]. Formula feeding, early introduction of solids, dietary composition, physical activity and electronic media use amongst infants and young children are associated with obesity in childhood [2].  Maternal and child health (MCH) nurses have frequent contact with parents of young children, offering an unparalleled opportunity for engagement to influence family lifestyle behaviours [3]. Little is known however, about the views and practices of MCH nurses regarding obesity prevention in early life. This study aims to explore the knowledge, attitudes, practices and support needs of MCH nurses on preventing obesity in children 0-5 years of age.

Methods

This was a mixed methods study drawing on a survey of 61 MCH nurses (87% response rate) supplemented with semi-structured interviews with 16 of these nurses across two local government areas in Melbourne, Australia. Survey data was analysed descriptively and interviews transcribed and coded for key themes. Survey data was triangulated with interview data to provide insight behind key obesity prevention practices, barriers and support needs.

Results

Around three quarters of staff reported measuring height and weight in infants and young children, however almost half did not use growth or BMI charts to identify infants or children at risk of overweight or obesity. Nurses expressed concern about raising the topic of overweight with parents due to a lack of confidence in tackling the issue and concerns about low parental receptiveness. A high proportion of nurses reported routinely providing advice and support on breastfeeding (55%), when and how to introduce solids (62 and 59% respectively), limiting sweetened drinks (60%) and intake of high fat/salt/sugar foods (55%) and encouraging family meals (52%).  In contrast, just over 40% of nurses reported routinely discussing active play, and less than 30% reported talking to parents about limiting young children’s TV viewing and use of other electronic media. The most commonly perceived barriers to addressing obesity prevention related to parental receptiveness, including a lack of parental recognition of child overweight (65.5%), concern regarding negative parent reactions (65.5%) and perceived lack of parent motivation to change diet or lifestyle (51%). 

Discussion

MCH nurses are well placed to address obesity prevention in early childhood, however nurses need further training and support in the area of promoting active play and limiting sedentary behaviours, raising the topic of childhood overweight as an issue with parents and fundamental counselling skills. 

References

1. Lobstein, T., L. Baur, and R. Uauy, Obesity in children and young people: A crisis in public health. Obesity Reviews, Supplement, 2004. 5(1): p. 4-104.

2. Monasta, L., et al., Early-life determinants of overweight and obesity: A review of systematic reviews. Obesity Reviews, 2010. 11(10): p. 695-708.

3. Goldfeld, S.R., M. Wright, and F. Oberklaid, Parents, infants and health care: Utilization of health services in the first 12 months of life. Journal of Paediatrics and Child Health, 2003. 39(4): p. 249-253.