Randomized Controlled Trial of an Early Child Obesity Prevention Intervention: Impacts on Infant Tummy Time

OBJECTIVE: To describe infant activity at 3 months old and to test the efficacy of a primary care-based child obesity prevention intervention on promoting infant activity in low-income Hispanic families. METHODS: Randomized controlled trial (n=533) comparing a control group of mother-infant dyads receiving standard prenatal and pediatric primary care with an intervention group receiving “Starting Early”, with individual nutrition counseling and nutrition and parenting support groups coordinated with prenatal and pediatric visits. Outcomes included infant activity (tummy time, unrestrained floor time, time in movement restricting devices). Health literacy assessed using the Newest Vital Sign. RESULTS: 456 mothers completed 3-month assessments. Infant activity: 82.6% ever practiced tummy time; 32.0% practiced tummy time on the floor; 34.4% reported unrestrained floor time; 56.4% reported >1 hour/day in movement restricting devices. Inadequate health literacy was associated with reduced tummy time and unrestrained floor time. The intervention group reported more floor tummy time (OR 2.16, 95% CI 1.44–3.23) and unrestrained floor time (OR 1.69, 95% CI 1.14–2.49) compared to controls. No difference in the time spent in movement restricting devices was found. CONCLUSIONS: Tummy time and unrestrained floor time were low. Primary care-based obesity prevention programs have potential to promote these activities.