Obesity prevention in early life: an opportunity to better support the role of Maternal and Child Health Nurses in Australia

Abstract

BackgroundBecause parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported.MethodsThis mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0–5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles.ResultsAlthough nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation.ConclusionWhile MCH nurses are well placed to address obesity prevention in early life, there is currently a missed public health opportunity. Improving nurse skills in behaviour change counseling will be key to increasing their confidence in raising sensitive lifestyle issues with parents to better integrate obesity prevention practices into normal MCH service delivery.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-015-0077-7) contains supplementary material, which is available to authorized users.

Lessons on early childhood obesity prevention interventions from the Victorian Infant Program

“…gain within their role, but required additional support to incorporate this into routine consultations. 11 Enhancements have been made to the content and delivery of the Infant Program. The Infant Extend Study explored providing program content through dedicated website pages, and introduced a closed and mediated Facebook group.…”

“…Given the high frequency of parent contact with MCH nurses in Victoria, an additional study explored the scope of MCH nurses to influence obesity prevention practices. 11 Almost one-quarter of MCH nurses reported never/rarely using growth charts to identify those at risk of overweight, reflecting a lack of confidence in addressing the issue of weight with parents. The majority of MCH nurses reported routinely providing advice on infant feeding; less than half routinely promoted active play; and only one-third discussed limiting sedentary behaviour.…”

Professional and non‐professional sources of formula feeding advice for parents in the first six months

“…Differences in the professional support or advice given to, or accessed by, those who are breastfeeding and formula feeding have been described in many recent studies (Laws et al, ; Newby et al, ; Tarrant et al, ). In the current study we found that although both breastfeeding and formula feeding groups reported comparable support with advice from MCHNs, this was not the case for the other professional groups examined, midwives and PNs.…”

Actions of nurses toward obesity in primary health care units

“…Corroborating these results, one study carried out in southern Brazil showed that encouragement to breastfeeding is one of the nurses' actions that aims at preventing and fighting childhood obesity (5) . In Australia, one study on guidance content regarding obesity provided during routine nursing appointments to children from zero to five years of age showed that most nurses advised parents on the different aspects of child nutrition (13) .…”