Researchers have found an association between psychological distress in mothers and obesity in their children. A team from Liverpool University, UK, examined the link using figures from the Millennium Cohort Study, which included nearly 19,000 babies born in the UK between September 2000 and January 2002.
The team, led by Dr. Lakshmiprabha Ramasubramanian, found that almost a fifth (18 percent) of the children were overweight at the age of three, and a further five percent were obese. Among the mothers, almost four percent scored highly on a scale which measures psychological distress, called the Kessler 6 scale.
When the team analyzed the figures they found that mothers with “serious psychological distress,” which included low mood and anxiety, were significantly more likely to have children who were overweight or obese.
“Our results suggest that maternal psychological distress is associated with a higher likelihood of early childhood obesity and may increase the risk of children being overweight at the age of three,” said Dr. Ramasubramanian. But he pointed out that the study has limitations, and there could be other important factors.
However, he added, “Childhood obesity has been described as a ‘global epidemic’ by the World Health Organization. With this is mind, it is clear that more needs to be done to investigate the many factors that contribute to childhood obesity. Further studies are needed to address factors that may be modifiable to be able to address the rising trend in childhood obesity.”
Findings were presented at the annual meeting of the Royal College of Psychiatrists’ Faculty of Child and Adolescent Psychiatry, Dublin, September 9-11, 2009.
A similar link was found by researchers at Harvard School of Public Health, Boston, Massachusetts. Dr. Pamela J. Surkan and her team looked at whether maternal depression is related to overweight in infants aged six to 24 months. They gathered data from 589 mother-child pairs living in low-income urban communities in Brazil.
They found that children of mothers with “high depressive symptoms” had around twice the risk of being above World Health Organization weight/height recommendations. A longer duration of breastfeeding (more than six months) reduced the risk, but it was increased when the mother had fewer than eight years of education.
“There is ample evidence of impairments in interactions between depressed parents and their children,” the team writes. In some deprived areas, the link with weight moves in the opposite direction. They report on a study of low-income families in Santiago, Chile, where “anxious mother-infant attachment was related to lower weight-for-age in young childhood.”
This is consistent with the failure to thrive literature, which documents the role of food-related interactions in growth delays, they believe. “Depressed caregivers may be less likely to perceive that a child is sick or respond to his or her needs, and they may be less able to coax the child to eat. Likewise, mothers with depressive symptoms may be less likely to engage in healthy feeding or sleep practices with their infant, less likely to breastfeed, and less likely to provide tactile stimulation.”
The authors suggest that caregiving behaviors such as sensitive interactions and positive engagement with a child, could affect the child’s growth. They conclude that programs focusing on mothers’ mental health, including prevention and treatment of depression, may result in collateral benefits for their children.
Dr. Atif Rahman of Manchester University, UK, supports this recommendation. He writes that maternal depression could affect infant growth via a less healthy lifestyle during pregnancy, maternal disability afterward leading to “deficient physical and emotional care and psychosocial stimulation of the infant,” and other difficulties such as lack of family support or financial problems.
Dr. Jacinta Bronte-Tinkew of Child Trends research center in Washington, DC, carried out research in this area and concluded that parental depression influences toddlers’ weight via food insecurity. Food insecurity was defined as “limited or uncertain availability of nutritionally adequate and safe foods, or limited or uncertain ability to acquire food in socially acceptable ways.”
“Our results show that food insecurity influences parenting, including both depression and parenting practices,” they write. It can operate through less desirable feeding practices, for example, reduced breastfeeding rates and early weaning.
“Our findings show that already by age two, food insecurity interferes with parent-child interactions and affects central aspects of development such as overall health and overweight,” they write, adding, “Policy initiatives should ensure that families with infants and toddlers have sufficient, predictable, and reliable food supply.”
Maternal distress may influence the child’s weight through many mechanisms, so early treatment of prenatal or postnatal depression is vital. It could benefit not only the mother’s mental health but also the infant’s physical health and development.
Surkan, P. J., Kawachi, I. and Peterson, K. E. Childhood overweight and maternal depressive symptoms. The Journal of Epidemiology and Community Health, Vol. 62, issue 5, May 2008, e11.
Surkan, P. J. et al. Maternal depressive symptoms, parenting self-efficacy, and child growth. American Journal of Public Health, Vol. 98, January 2008, pp. 125-32.
Rahman, A. et al. Impact of maternal depression on infant nutritional status and illness: a cohort study. Archives of General Psychiatry, Vol. 61, September 2004, pp. 946-52.
Bronte-Tinkew, J. et al. Food Insecurity Works through Depression, Parenting, and Infant Feeding to Influence Overweight and Health in Toddlers. The Journal of Nutrition, Vol. 137, September 2007, pp. 2160-65.