New research suggests that the routines parents build in the earliest weeks of life may play a role in how babies grow during their first months. The study, published in JAMA Network Open and led by Penn State researchers, found that certain feeding, sleep and play habits reported when infants were 2 months old were linked to higher weight at 6 months.
The findings are based on data from 143 mothers and infants receiving care through the Geisinger Health System and participating in the WIC program in northeastern Pennsylvania. While the sample was relatively small, the work gives pediatricians and nutrition professionals an early screening tool for talking with families about routines that influence growth.
“By just 2 months of age, we can already see patterns in feeding, sleep and play that may shape a child’s growth trajectory,” said lead author Yining Ma, a doctoral student at Penn State. She added that early screening may help families “prevent excessive weight gain and help every child get off to the best possible start.”
The researchers used the Early Healthy Lifestyles (EHL) tool, a 15-item questionnaire that asks parents about daily routines such as feeding cues, bottle size, nighttime awakenings, tummy time and screen exposure. They identified nine behaviors at 2 months that were associated with higher BMI and weight-for-length z scores at 6 months. For each additional behavior reported, infant weight measures increased on average.
Examples of behaviors linked to higher weight included:
using larger bottle sizes than an infant may need
nighttime feeding
putting a baby to bed after 8 p.m.
waking two or more times during the night
having a TV on in the room where an infant sleeps
putting a baby down already asleep rather than drowsy
limited tummy time
feeding to soothe when the infant does not show hunger cues
parent screen use during play
These behaviors are common, often well-intentioned and influenced by fatigue, time constraints and competing advice from different sources. The authors emphasize that none of these routines alone determine a child’s long-term growth and that early guidance should focus on support, not judgment.
“With the limited time available during pediatric and nutrition visits, it’s essential to help providers focus on what matters most for each family,” said senior author Jennifer Savage Williams, professor and director of The Child Health Research Center at Penn State. She explained that a tool like the EHL can highlight which routines may benefit from extra attention, helping providers tailor guidance to each family’s needs.
The study also notes that many families, especially in low-income settings, face challenges related to food access, child care schedules and inconsistent messaging from different programs. The researchers hope to expand their work to include more diverse populations and to understand how groups of behaviors interact over time.
For families, the takeaway is that small, consistent routines around feeding, sleep and play can support healthy development, and that responsive caregiving, paying close attention to an infant’s cues and responding appropriately, may help children build self-regulation skills as they grow.
As pediatric research continues to evolve, tools like the EHL may help simplify conversations during short well-child visits, offering parents clearer guidance during a time when information can feel overwhelming.
This study was supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services and by the National Center for Advancing Translational Sciences at the National Institutes of Health.