{
  "abstract": "How often do you discuss ‘Responsive Positive Parenting’ with your families? What is it, and does it have any effect? The INSIGHT study (Intervention Nurses Start Infants Growing on Healthy Trajectories) has been conducted by Paul IM et al (JAMA Pediatr 2025;170(8):827–855. doi:10.1001/jamapediatrics.2024.6897) and has examined the long-term impact of positive parenting on obesity in childhood in a randomised clinical trial design. ‘Responsive parenting’ intervention provides less than 10 contact hours of health visitor guidance that advises parents on how to respond to their child’s needs across four behavioural states: drowsy, sleeping, fussy and alert (ie, interactive play and feeding). In this study, research nurses conducted four home visits during infancy and annual research centre visits. The responsive parenting curriculum focused on feeding, sleep, interactive play and emotion regulation. The control group received a home safety intervention that was dose-matched to ensure equivalent time and intensity. The intervention was delivered via mailed instructions at 2 weeks, with nurse home visits at the child’s ages 3 to 4, 16, 28 and 40 weeks; research centre visits at 1 and 2 years; and telephone contacts at 18 and 30 months. No intervention was performed during the observational follow-up. This was an observation-only, long-term follow-up of 232 participating primiparous mother–child couples. Over 5 years, the mean body mass index (BMI) from ages 3 to 9 years was significantly lower in the responsive parenting intervention group compared with controls (116 per group, 16.59 vs 16.95; absolute difference, −0.36; p=0.049). However, the intervention’s association appeared to dissipate over time and gender moderated this association; female participants in the responsive parenting group had a lower mean (SE) BMI than female participants in the control group (16.31 (0.23) vs 17.24 (0.22); absolute difference, −0.93; p = 0.002), with no group differences among male participants. There were no differences in BMI z scores or prevalence of overweight or obesity at ages 5, 6 and 9 years between the responsive parenting group and the control group. It is a pity that by age 9 years, there were no overall study group differences in any weight-related outcome, including BMI and proportion of children with overweight or obesity. So, early life positive parenting seems to have an impact—although this study does suffer from the p value of p=0.049. … just significant, rather than just insignificant (statistically). How much does a difference of 0.36 in a BMI really mean clinically—what is the effect on long-term clinically relevant outcomes? Positive parenting sounds like a great idea. But it appears to be needed throughout life to have an impact. If it stops, this association wears off. The Archivist knows that this is the case in most families; even when the child is an adult, positive parenting will always be required! The study concludes that a life-course approach may be required to sustain benefits for obesity prevention. This is, I am sure, true… but hard!",
  "authors": [
    {
      "affiliations": [],
      "name": "BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health"
    }
  ],
  "title": "Positive parenting and obesity: the INSIGHT study",
  "uid": "9426970d-19bb-52b4-9a48-3eea55dfe289"
}