Obesity in very young children is a common health issue. It occurs when the toddler`s BMI (height and weight ratio) is above the child`s age. Many factors have been linked with obesity in toddlers, including genetics, overall lifestyle habits, and inadequate body exercises among other contributing factors.
The health effects of toddler obesity are similar to those in adults. Short term risks of toddler obesity include; risks to cardiovascular diseases, high blood pressure and cholesterol, respiratory problems such as asthma and joint complications. Long term risks include severe obesity during adulthood, very high risks of acquiring type II diabetes or cancer. The general physiological effects that have been reported among toddlers with obesity are deep anxiety, depression and lower self-esteem later in life, when the child`s emotions can be easily expressed.
What are the maternal factors that cause obesity in toddlers?
The toddlers diet is a contributing factor to obesity for example poor diets and feeding the toddler huge food portions with a fatty nutritional profile. Research says that children who are fed below 4 years of age are likely to be obsessed later in life. Before birth, obesity is likely to manifest in the young child if the parents are obese (Hassink, 2016).
Physical inactivity of very young children also causes overweight and obesity. Most parents under estimate the physical exercise phenomenon in toddlers such as engaging the in adequate play environment and simple outdoor actions. Through assessment of these factors, the overweight condition can be prevented for example by breastfeeding young children, keeping them active and ensuring a general healthy habit from throughout. The research will focus on maternal issues related to obesity in toddlers in a detailed literature review.
Toddler obesity has over time been though as an unfortunate failure of self-restraint to controlling the level of consumption of carbohydrates. On the contrary, research has established that obesity in toddlers has more complex and much deeper causes than first thought. Maternal factors of toddler obesity are of study interest in the nursing sector. There are various risk factors that comprise maternal factors which cause this condition. Firstly, biological factors such as pregnancy problems, maternal diabetes, delivery method, foetal growth and gestational age at birth play a critical role in toddler’s propensity to add excess weight. In addition, parental factors such as pre-pregnancy BMI of the mother, gestational weight increase, diet and nutrition of the mother, maternal stress, age at delivery, and paternal factors have been shown to influence obesity in toddlers. Finally, environmental and community factors including prenatal health care and ecological pollutant exposure respectively, tobacco use of the mother, prenatal substance use, and medication shape the toddler’s trajectory of gain of weight and general body fatness (Chaildez, 2016).
Toddler obesity has also been shown to be associated with diabetes, mother obesity, and other chronic conditions. As such, it is evident that toddler obesity has developmental origins including preconception, foetal and infant developmental periods. During each of these stages, multiple factors have been established to have significant impacts on toddler obesity. These factors including basic prenatal and developmental influences on toddler obesity are outlined in the next section.
Uterus offers warmth, nutrients and hormones which are fundamental to foetal development. Fluctuations in any of these conditions at sensitive periods of foetal development result in toddler obesity. Six key biological factors which cause toddler obesity include maternal gestational obesity, pregnancy complications, delivery method, maternal BMI, diet and nutrition, and maternal stress.
The condition causes excessive gain of weight to the foetus and the “assumption “is that the infant gets over fed due to increased high exposure to glucose, amino acids, plasma concentration and free fatty acids (Garcia,2016). Higher insulin levels in the foetus raises the body fat and causes increased body size at birth. The long term effects are higher appetite and elevated energy metabolism.
The consequential effect due to paternal diabetes as a contributing factor to toddler obesity has not yet been identified. The mother may have a constant or normal glucose level but an increase glycaemia index during pregnancy is a risk to children obesity during other stages of growth. A proper diabetic treatment during pregnancy and post pregnancy has been shown to eliminate toddler obesity or gain of weight as the child grows.
Research indicates that there is a high link between maternal obesity and toddler obesity. The higher the weight of the pregnant mother, the higher the risk of toddler obesity (Cerdo,2018). For example, a 24kg weight gain in pregnant mothers causes an extra 147g weight gain to an infant at birth. The condition is caused by increased fats to the foetus due to higher calories which elevate the energy metabolism during development. Fat is deposited in form of an adipose layer in major organs of the foetus such as the heart, liver and muscle (Maville, 2009). Non-fats cells also synthesize peptides, hormones, cytokines and chemokine at increased levels which have an impact on the local body physiology and general pathology effect on toddler obesity.
Toddler obesity increases the susceptibility to chronic metabolic disorders such as asthma and diabetes (Chi, 2017). There are also risks to the pregnant mother during this circumstance such
as high blood pressure, risks of caesarean delivery, cardiovascular diseases and type II diabetes. Maternal obesity during pregnancy can also cause gestational diabetes which influences toddler obesity through the parameters described above.
Caesarean section delivery has a direct impact on over nutrition in toddlers, which causes obesity if not closely monitored.
Maternal height was measured in the first follow up at three months post – partum which was classified in accordance to the WHO guidelines (Hassink, 2016). The categories included, underweight which was (< 18.5 kg / m2), Normal weight at (18.5 – 24.9 kg / m2) and obese which was considered to be (30.0 kg / m2). According to the above findings then it was easy to analyse the riskiness of a toddler being obese (Chaildez, 2009). Recommendations were that the doctors should introduce effective measures to reduce the maternal overweight in a certain period before pre – conceptual. Also there should be considerations of the long term effects on the maternal – child outcomes. To further evaluate the effects of maternal pre – pregnancy body mass index (preBMI) and gestational weight gain (GWG) on neonatal birth weight (NBW), we did a research survey on a population of Australian healthy pregnant women. This research also attempted to guide on different ways controlling weight in pregnancy.
The research focused on 3772 pregnant women. The population was classified under the following categories; underweight, normal weight, overweight and obesity. The NBW differences were tested among the four categories. Multivariate analysis was conducted in order to investigate the effects of maternal pre – BMI, GWG, and NBW. One of the findings was that NBW increased with an increase in maternal pre – BMI level denoted at (p< 0.05) but overweight and obesity with (p > 0.05) was not affected. The analysis further indicated that pre – BMI level and GWG were positively correlated with NBW (Hassink, 2016). This was denoted as (p<0.05).
In comparison with the normal pre – BMI, underweight there was an increase in the ration odds for the small gestational period (SGA) and the odds ratio decreased in the macrosomia and large gestational age (LGA). When the results were compared to overweight, they denoted an opposite outcome. An increase in GWG significantly reduced the SGA risk. This led to an increase in macrosomia and LGA risks. The analysis also found out that the effects of weight gain in the first trimester on NBW were different (p<0.05). NBW was affected by maternal pre – BMI and GWG in a positive way. Extreme conditions of GWG and pre – BMI increased the risk of giving birth with abnormal weight (Hassink, 2016). The other crucial finding was that maternal pre – BMI modified the effects of weight gain in each trimester on NBW. There was a need to validate the GWG guideline for the Australian pregnant women. The existing recommendations did not favour the Australian women.
The dietary intake during pregnancy and in early childhood always affects child health at different ages. There was insufficient evidence to support beneficial effect of consuming fatty acid, caffeine, and sugar (Cerdo, 2016). There was a need to advance studies in prenatal dietary patterns and plausible mechanisms.
Stress during pregnancy is one the factors that lead to an increase in obesity of a toddler. There was a research analysis on different categories of parental stress such as social stress, financial stress and parenting stress. These factors were closely related to the rate of obesity in toddlers(Buckely, 2016).
Mothers parenting stress also increased the rate of obesity in toddlers. This kind of stress is characterized by a dysfunctional child to parent’s relationship which in turn affects the parenting behaviour. More also stress in toddlers causes hypothalamic pituitary adrenal axis
(HPA) and releases more stress hormones. One of these hormones is the glucocorticoids which is associated with affects metabolic syndrome and visceral adversity. Generally there is a need to study more on the maternal stress patterns and plausible mechanisms. Identification of physical activity patterns helps to promote healthy weight gain.
Caesarean section delivery has an indirect impact on over nutrition in toddlers, which causes obesity if not closely monitored. The connection of CS delivery with childhood obesity is higher Body mass index of the mother which increases the likelihood of overweight in the infant and obesity at birth and in later life stages. The hypothesis in this findings show that caesarean delivery is not the main causative factor. It is as a result of maternal obesity or overweight during pregnancy
Conclusion
The study review fully acknowledges how maternal factors contribute to obesity of childhood at a very young age, which has a major effect later during adulthood if untreated. Biological factors occur due to natural disorders or problems during pregnancy. The toddler parent or caregiver contributes to childhood overweight due to factors that affect the biochemistry nature of the infant growth. However, other factors such as paternal aspects, maternal age at delivery and paternal medication had an insignificant evidence to support their influence on toddler obesity. Environmental factors surrounding the pregnant mother showed a significant influence on the condition. For example, tobacco use causes adiposity of the offspring. Use of hard drugs such as cocaine also causes overweight of the toddler.
Based on the findings of the studies that have been carried out to determine the factors that cause toddler obesity, it is clear that lifestyle and nutrition factors at the time of preconception, foetal development, and after delivery have profound effects on toddler obesity. Despite toddler obesity being common currently, the causative factors occur during optimal time for carrying out intervention measures. To begin with, women are more receptive during the preconception period to ensure that they raise healthy infants. As a result, they would embrace changes in lifestyle aimed at ensuring that the health of the infant is not at stake. In addition, women would be more willing to initiate changes in lifestyle to after the birth of the baby to guarantee raising a healthy infant. Clinicians can therefore maximize these sensitive periods in order to reduce the cases of toddler obesity. For instance, the clinicians could advise the women to strive for healthy weight prior to conception and set to gain
Future research should be conducted to determine if there is any influence of toddler obesity on the findings that were found to have low evidence. Research on the intervention mechanisms, their short term and long term effects in solving the maternal factors should be done in order to come up with a strong recommendation. The connection of previous pregnancies and their influence on toddler obesity in subsequent pregnancies would be of key interest in this research. In addition, the genetic risk factors concerning the father`s influence on child obesity should also be researched on. Ethical considerations in future research to base the research on a wide racial diversity for example Whites, Africans, Asians, Europeans and Hispanics should be ensured in order to base the research arguments and trends on a wide population scale.
References
Buckley, R (2016). Children obesity. Bloomfield: Mercury Learning & Information.
Cerdo, T., Ruiz, A., Jauregui, R., Azaryah, T., Torres-Espinola, F, J., Garcia-Valdes, L., Teresa, S, M., (2018). Maternal obesity and metabolic potential in offspring during infancy
Chaildez, V (2009). Toddler feeding practices in Latinos. An early start in obesity prevention.
Chi, D, L., Luu, M., & Chu, F. (2017). A scoping review of epidemiology risk factors for pediatric obesity: Implications for future.
Garcia-Mantrana, I., & Collado, M, C. (2016). Obesity overweight. The impact on maternal and milk microbiome.
Hassink, S. G., & In Hampl, S. (2016). Clinical care of the child with obesity: A learner’s and teacher’s guide.
Maville, J, A., & Huerta, C, G. (2009). Health promotion in nursing. Clifton Park, NY: Thompson Delmar Learning.
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