Rapid weight gain (RWG) during infancy is a critical predictor of future obesity and related health issues. This study surveyed Well Child Tamariki Ora (WCTO) practitioners to assess their knowledge and practices regarding RWG during infancy. The survey aimed to explore WCTO practitioner recognition of RWG, discuss approaches with families on this topic and test agreement with proposed guidance points for managing RWG.
164 WCTO practitioners, predominantly nurses completed the web-based survey during February to June 2023, a 25% response rate. Respondents were widely spread across New Zealand, had a wide mix of experience, and an ethnicity mix that matched the NZ population except for an under-representation of Asian practitioners.
Results indicated high engagement in monitoring infant growth (both poor and excessive weight gain), with 94% of practitioners regularly measuring infant weight and 97% looking for poor weight gain. However, recognition of RWG during infancy was limited, with 84% identifying it in only 1 in 10 infants or less contrasting with expected rates of 1 in 2. Practitioners commonly discussed feeding regimes, activity levels, and sleep patterns with families upon recognising RWG. Good practice principles aside, parents' ethnicity, breastfeeding status and familial obesity moderated practitioner manner (64-71%) and discussion topics (52-78%).
WCTO practitioners expressed high agreement with the proposed guidance points, emphasizing continued breastfeeding and careful assessment of feeding practices. Most WCTO practitioners identified a need for further professional development and found potential value in an electronic support tool for identifying and managing RWG during infancy in the ‘Well Child’ setting.
The study highlights the need for clear guidelines and enhanced training to improve recognition and management of RWG among WCTO practitioners, adapting practice and messaging for parents of different culture and consistent care for the prevention of later obesity.