Breast Feeding and Childhood Obesity - Assignment Example

 Breast Feeding and Childhood Obesity Title To evaluate the effect of breast feeding on the risk of development of childhood obesity Aims and objectives To ascertain the relationship between breast feeding in infancy and the impact on the risk of development of obesity in childhood Background and rationale Childhood obesity is a health concern of great magnitude. It is occurring in epidemic proportions is the world. Obesity in a child is defined as Body Mass Index (BMI) above 95th percentile for age and gender and over weight is defined as BMI between 85th and 95th percentile (Noller and Paulk, 2005). Childhood obesity and overweight are a matter of concern because of the potential health problems they are associated with like hypertension, type-2 diabetes, respiratory ailments, orthopedic problems, trouble sleeping and depression (Noller and Paulk, 2005). It has been estimated that 80% overweight adolescents continue to be obese in adulthood (Noller and Paulk, 2005). Added to these problems, childhood obesity imposes huge health care costs on the nation (The Role of Media in Childhood Obesity, 2004). Childhood obesity and overweight also increase the risk of cardiovascular disease in adulthood (Eisenmann, Bartee and Wang2002). Obesity usually begins at 5-6 years of age and then during adolescence. There are reports that obesity between 10- 13 years of age is likely to advance to adult obesity (AACAP, 2008). Thus, measures to prevent childhood obesity become very essential to decrease mortality and morbidity in adulthood. One such measure is breast feeding. Research has shown that breast feeding has several benefits both to the mother and baby. One such benefit is protective effect of childhood obesity. In this study, the protective effect of breast feeding during infancy on the development of obesity in childhood will be evaluated and ascertained. Hypothesis The hypothesis tested in this study is "breast feeding in infancy decreases the risk of childhood obesity." Inspiration from reflection The observations made by the researcher during clinical practice and field visit placements have inspired him to conduct this research. Childhood obesity is a challenge to the society and the physicians. It leads to adult obesity and is associated with mortality and morbidity. This aspect inspired the author to conduct research. As Burns and Grove (1997) stated, clinical experience frequently gives rise to the identification of a research topic and expands scope for reflection. Reflective practice is essential to clinical practice and provides a retrospective look at current practice and questions the reason for doing so. Thus, it is because of reflection that the author was able to raise questions which prompted to this research study. Literature review Several studies have been conducted in the past to ascertain the impact of breast feeding in early years of life on the development of obesity later in life. According to a study conducted by von Kries, Koletzo, Sauerwald et al (1999), there exists a clear dose-response relationship between the duration of breast feeding on the prevalence of childhood obesity and overweight. According to the study, breast feeding has a protective effect on the development of obesity and overweight. In their study, the prevalence was "3.8% for 2 months of exclusive breast feeding, 2.3% for 3-5 months, 1.7% for 6-12 months, and 0.8% for more than 12 months" for obesity and overweight. The authors concluded that prolonged breast feeding is a useful preventive measure for the development of childhood obesity and overweight and that such a measure will decrease the prevalence of cardiovascular diseases and other morbidity and mortality associated with obesity. According to a systematic review conducted by Arenz, Ruckerl, Koletzko et al (2004), breast feeding has a "small but consistent protective effect against obesity in children." In the meta-analysis of the study, "the adjusted odds ratio was 0.78, 95% CI (0.71, 0.85) in the fixed model." In the study by Bergmann, Bergmann, Von Kries et al (2003), the researchers proved that bottle feeding in early days of life is predictive of obesity later in life. In another study by Owen, Martin, Whincup et al (2005), it was ascertained that the mean BMI is lower among breast fed subjects throughout lifetime when compared to those who are top fed. Such and other studies have implied the role of breast feeding in the prevention of obesity. Materials and methods Methodology is a means of justifying the articles selected for the review. The methodology must be essentially extensive and detailed. Planning is essential for proper methodology. For proper planning, organization of focus question is essential and helps in thorough search for relevant literature. Reviews are labor intensive and require a lot of skill in terms of the searching technique and the actual reviewing (Parahoo, 2006). In due anticipation of a long and involved task, the researcher will keep a log book where important information, results obtained and arising issues will be recorded as when obtained. A mind map will be employed in developing the important facets of the focus question. Mind-map is a visual, non-hierarchical display of similar items. Mind maps help in the creative organization and communication of ideas, in making decisions and in problem solving (Knight, 2002). Setting The study will be conducted over …. years from… to ….. . It will be conducted in …the colleges of the area….. Study design This will be a cross-sectional survey. Participants The study will be conducted in schools which will be enrolled in the study after taking prior consent from the authorities of the school. Only students of United States origin will be enrolled in the study for the purpose of uniformity. The study will be conducted on children between 5-6 years of age. The body mass index of the children will be ascertained and the parents of the children will be provided a detailed questionnaire from which data for analysis of the study will be computed. Data assimilated from the children Name, age, sex and location will be recorded from school data. The wight and height of the children will be recorded as a part of physical examination. Body mass index or BMI will be calculated from this information using the formula BMI = weight (kg)/(height (m)2. BMI above 95th percentile for age and gender will be considered as obesity and BMI between 85th and 95th percentile will be called over weight. Inclusion criteria 1. The child must be between 5- 6 years of age 2. The child must belong to one of the schools registered for the purpose of study 3. The child must be of US origin Exclusion criteria 1. Chronic health problems in the child 2. Mental health illness in the child 3. Premature delivery 4. Children of non-US origin Questionnaire The questionnaire to the parents will be as follows: 1. Name of the child 2. Date of birth and current age 3. Sex 4. Location 5. Nationality 6. Ethnicity 7. Birth details 8. Gestation at the time of delivery a. Less than 37 weeks b. 37- 38 weeks c. More than 38 weeks 9. Immediate birth problems 10. Was your child breast fed? a. Yes b. No 11. Duration of breast feeding a. Less than 3 months b. 3-6 months c. 6- 12 months d. More than one year 12. Was the breast feeding exclusive during the first 6 months? (Exclusive breast feeding means the infant being fed no other food than breast milk) a. Yes b. No 13. If top feeds were used, how much of it was used? a. Less than 25 percent b. 25- 50 percent c. More than 50 percent 14. When were weaning foods introduced" a. less than 4 months b. 4-6 months c. Beyond 6 months 15. Does the child have any health problems? a. Hormone problems b. Problems of alimentary tract c. Chronic diseases Measures The predictor variable in the study is breast feeding. This will be determined by asking the parents about the duration of breast feeding and the exclusiveness of breast feeding by administering the questionnaire. Outcomes that will be measured The main outcome measured is obesity. Other outcome measured is overweight. Statistical analysis The prevalence of obesity and overweight will be calculated according to the duration of breast feeding. Appropriate chi square tests will be used to compare several items among breastfed and nonbreastfed children and their association with the child being obese or weight. Logistic regression models will be used to ascertain the impact of variables significantly associated (p Read More