![]() Of the many factors contributing to early onset of childhood obesity, research has found that infant feeding practices, including breastfeeding and the timing of the introduction of solids as well as children’s eating habits and television (TV) viewing time are among the most modifiable. Indeed, a 2013 Lancet editorial argued that prevention, through educating mothers about both nutritional and environmental exposures of in-utero and during early life is an important strategy in the prevention of non-communicable diseases. There was a call for greater efforts being made to prevent childhood obesity in the early years, and even before birth. ![]() The adverse health consequences of childhood obesity are well documented internationally, and in Australia obesity in very young children is associated with increased healthcare utilization. Obesity in pre-school aged children has a high risk of progressing to obesity in later childhood and potentially into adulthood. It has now become evident that excess weight and fast weight gain in young children are associated with overweight later in life. In Australia, approximately 20% of children at 2–3 years of age are overweight or obese. The importance of early intervention in the first few years of life to prevent the development of overweight and obesity is evident, with a global prevalence of overweight being 6.7% of children under the age of five in 2010. The CHAT Trial is registered with the Australian Clinical Trial Registry ( ACTRN12616001470482p). If proven to be feasible, effective as well as cost-effective, the trial results will inform a series of recommendations for policy and practice related to promoting healthy infant feeding and physical activity in young children in the first years of life. The results will ascertain whether early intervention using telephone consultation or text messaging together with staged mailed intervention resources can be feasible and effective in improving infant feeding practices, physical activity and reducing children’s BMI in the early years of life. The main trial outcome measures include a) duration of breastfeeding, b) timing of introduction of solids, c) nutrition behaviours, physical activity and television viewing, and d) weight and BMI z-score at 12 and 24 months, e) cost-effectiveness, as well as f) feasibility and acceptability of the interventions. The intervention comprises telephone consultations or text messages, together with 6 intervention packages being mailed at specific times from the third trimester of pregnancy until 12 months post birth. Informed consent will be obtained, and after baseline data collection, participants will be randomly allocated to the telephone intervention, text messaging intervention, or the control group. Pregnant women who are between weeks 28 and 34 of their pregnancy will be invited to participate in the CHAT trial. We propose a 3-arm randomised controlled trial (RCT) with a consecutive sample of 1056 mothers with their newborn children in New South Wales (NSW) Australia. This trial aims to determine the efficacy of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants in improving infant feeding practices and preventing the early onset of childhood overweight and obesity. However, the costs for scale-up of home visiting limit its population reach. A previous Healthy Beginnings Trial using a nurse-led home visiting program has demonstrated that providing mothers with evidence-based advice can improve maternal practice regarding obesity prevention, and can reduce Body Mass Index (BMI) in the first few years of life. With an increasing prevalence of obesity in young children globally, there is an urgent need for the development of effective early interventions.
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