Trees beat TV

BABIES are better off in the kitchen watching their mothers cook the evening meal or even looking out the window at trees than being stuck
in front of the TV set, say researchers at Deakin University.

How parents can be persuaded that television is not the best child-minder is a challenging task the researchers have taken on as part of an
obesity-prevention project.

Although the results of the investigation are not complete, the team from Deakin's Centre for Physical Activity and Nutrition Research has already shown that
first-time parents can be helped to make their young children's lives
more active and healthier — and persuaded to be cautious about how much
TV their babies watch.

Lead researcher Dr Kylie Hesketh says obesity-promoting behaviour, including sedentary habits, become well established in early childhood. She describes the research
project, titled the Melbourne Infant Feeding Activity & Nutrition
Trial (InFANT) program, as "a controlled trial" involving 559
first-time mothers.

"We decided to target first-time parents because obesity-prevention projects tend to start when children begin school," she says. "But a lot of the behaviours are
already established by that time, which makes it more difficult to
change them."

By offering advice to first-time mothers as they are developing their parenting practices, the program is intended to provide ideas and strategies about food and activities
that are good for their children.

"If a mother starts by giving their baby or young child juice or soft drinks when they are thirsty, it is hard to get them back to drinking water later
on," Dr Hesketh says. "But if you start with water, and that is the
only drink they are offered, they are happy going along drinking
water."

The researchers enrolled the first-time parents within existing social groups established by local maternal and child health services workers. The mothers usually meet with the
maternal health nurse for six weeks, beginning soon after a baby is
born, and often they tend to go on meeting socially.

Dr Hesketh says half the parents who volunteered to take part were the control group and did not receive advice but did fill out
questionnaires and agreed to telephone interviews during the 15 months
of the trial.

The other half of the mothers were in the InFANT program. Members of the research team met the mothers for two hours on six occasions over the 15 months to talk to them about
what had been happening and what would happen with their babies as they
grew.

"We give them ideas as to what they might encounter and how they could deal with issues before problems arise," Dr Hesketh says. "We discussed what they might do when the baby started
moving around and we focused on healthy eating and feeding strategies
to avoid food refusal and to help mothers know how to deal with that."

She says a key aim of the instruction sessions was to show mothers how to give the child opportunities to be active, how to play with the baby in
an active way, teaching them ball skills and, especially, how to limit
time in front of the TV.

"Ideally, children under two do not need any TV time at all, so we gave the mothers different ideas for engaging the child while making the dinner, when they often
feel they need to put the baby somewhere to be entertained.

"But in front of the TV is not the place. Babies are quite happy before they start moving around to be sat in front of a window to watch the trees
or in the kitchen to watch the mother prepare the meal."

In addition to the information sessions, the researchers met with the mothers before the trial began, when babies were aged about three
months, again when they were nine months and at end when the babies
were 18 months. During this time, their height and weight were
measured, detailed food records were taken by phone interview and
information about the kinds of activities the babies were involved in
and their TV habits were recorded.

By the time the babies were nine months old, the evidence already showed the program was having an effect.

Dr Hesketh says that compared with the mothers in the control group, a significantly lower proportion of those in the program believed
television was educational (66 per cent versus 41 per cent), was
helpful for development (66 per cent versus 47 per cent), and that
young children should be allowed to watch TV (80 per cent versus 53 per
cent).

"Mothers in the intervention group were also less likely to report allowing their infant to watch television daily," she says. "On average, the babies in the trial watched 20
minutes less television per week than those in the control group."

Dr Hesketh says one of the trial's major achievements was that 91 per cent of the parents stayed with the program for the whole 15 months and
continued to fill in onerous questionnaires and take part in the
telephone interviews.

"If we confirm our hypothesis that such a program can have a long-term impact on parental behaviour we'd breathe a huge sigh of relief. We are currently submitting grant
applications to follow up these children when they are aged three and
five to determine if there are longer-term results," she says.

"That is an important point governments and health promotion groups always want to know: not just whether an intervention program has an effect
during a trial but if that effect is ongoing. If it isn't, it is
probably not useful."

Once the researchers have compiled the final results, they will have discussions with government departments and other groups that might consider using this type of
program with all new parents.

"We designed the project very much with a public health focus, which is why we used existing social groups and the maternal child health structure," Dr
Hesketh says. "We kept the meetings down to one every three months so
it could be cost-effective and able to be rolled out to all parents if
it is shown to be effective."