Background

A range of interventions have been developed and trialed to address the challenge of excess infant weight gain. Several reviews have focused on intervention studies aimed at preventing overweight or obesity among general populations in this age group. To our knowledge, there are no systematic reviews addressing interventions specifically aimed at managing the weight of infants aged 0-2 who have established risk factors or excess weight gain.The objective of this review is to examine interventions that aim to manage the weight of infants at increased risk of overweight or obesity before the age of two years, and to assess the effectiveness of interventions.

Methods

We included any interventions, commenced prior to age two years, aimed at maintaining a healthy weight in infancy and later childhood, addressing infant diet or physical activity. Interventions limited to those delivered to parents or other primary caregivers of infants aged 0-2. During June 2019, we searched six common databases, limiting references from 2006 onward.

Results

We screened titles and abstracts, and retrieved 486 full articles for review. 432 were excluded; the most common reason for exclusion was that the article was a systematic review (n=91) or that the study did not target infants with any specific risk factor for later overweight (n=73). Overall, 39 articles met all inclusion criteria. Most (n=19) were from the US, four in the UK, three in Brazil, two in Australia and one each in Denmark, Finland and Ireland. The majority (n=24) reported randomized controlled trials. Many studies focused on infants living in low-income or socially disadvantaged areas, sometimes in combination with other risk factors. Responsive feeding, bottle use, sleep and settling were all target behaviors.

Conclusions

Evidence of effective strategies to reverse excess weight gain is needed to to support high risk families. This review suggests that strategies aimed at bottle use, responsive feeding and enhancing sleep are potential targets.