Prevention: If not pediatricians, then who?

January 1, 2011

During my medical school pediatric clerkship, I was assigned to spend one half-day per week at the office of a private pediatrician. Over time, it became clear that pediatricians must be active partners with parents in decisions regarding infant feeding and other activities if the disturbing trends of obesity are to be reversed.

During my medical school pediatric clerkship, I was assigned to spend one-half day per week at the office of a private pediatrician.

That incident took place in 1974. Since then, the prevalence of obesity (defined as a body mass index ≥30) among children 2 to 5 years of age has increased from 5% to 12.4% and from 6.5% to 17% among 6- to 11-year-olds. The long-term consequences of overweight and obesity are well known and include hypertension, atherosclerosis, bone and joint disease, and insulin insensitivity, as well as social and emotional disadvantages. It seems quite clear that pediatricians must be active partners with parents in decisions regarding infant feeding and other activities if these very disturbing trends are to be reversed. And it seems equally clear that efforts to prevent overweight, obesity, and their consequences must begin in infancy.

I don't know whether the mother of that overweight infant I saw as a medical student would have accepted advice to reduce her son's caloric intake for the sake of his future health. I suspect, however, that if her pediatrician had highlighted his weight gain and emphasized the link between overweight during infancy and its potential to shorten or compromise his later life, she would have paid some attention. And I know that it is no longer acceptable not to make the attempt.

DR MCMILLAN
Editor-in-Chief
Contemporary Pediatrics