Q: Can we have updates on how the study is progressing? 

Yes, updates on the progress of the study can be found on the START study website http://www.southasianbirthcohort.com/Home 

You can also contact your site study coordinator for any updates and publications.

Q: Why do we measure weight, height and body fat percentage?  

We are trying to determine the environmental and genetic factors that cause obesity (overweight) and type 2 diabetes starting from the early stages of life. By following up on the weight, height, body fat percentage starting from the birth of the child, we are able to determine the association between the genetic, pregnancy and environmental factors and their impact or effect they have on these measurements as the child grows.   

Q: What are you testing in breast milk?   

The composition of breast milk reflects maternal dietary intake and other environmental exposures. These components may be linked to overweight and diabetes in the growing child. We will analyze the composition of breast milk to understand how it is affected by the different environmental factors, like for example the type of diet of the nursing mother, feeding practices…etc.    

 Q: Why do you collect a stool sample?? 

The composition of the ‘good’ bacteria (microflora) in the intestines of the baby may be linked to the development of the child’s immunity and how the body of the growing child metabolizes food. Many factors shape the composition of the intestines flora during the baby’s early years, like early delivery, the type of infant feeding, hospitalization, antibiotic use, components of breast milk, formula and solid foods and feeding practices . We would like to analyze the composition of the stool to understand the factors that shape the composition of the bacteria in the baby’s intestines and the connection this could have with diseases related to allergy, asthma, and overweight in the growing child.   

Q: Is iron testing for my baby necessary?  

Iron deficiency is believed to be higher among South Asian infants in Canada. Babies and children need iron for good health and development and mostly for their brains to develop normally. When our babies don’t have enough iron, red blood cells can’t carry enough oxygen to their body’s organs and can make babies develop slower, have no appetite, be less physically active, have slower weight gain, pale skin and be more irritable (cranky or fussy). It is important to diagnose and treat iron deficiency early as it can affect how older children do in school. If you agree to have your infant’s blood drawn at the one year follow up, we will send a copy of the results to your child’s primary care physician. For more information on iron needs in babies & children, you can request a brochure from your site coordinator and visit the website of the Canadian Pediatric Society – Caring for Kids:http://www.caringforkids.cps.ca/handouts/iron_needs_of_babies_and_children  

Q: Why do you ask so many questions in your questionnaire — like seeing English or Indian movies and my husband’s income? 

Questions like seeing English or Indian movies help us know how related and connected you are to your culture. Research shows that people who stay connected to their culture seem to have greater social support and may be healthier. We are trying to determine how your relation to your culture can affect the development of overweight and type 2 diabetes. Asking about your family income helps us determine your socioeconomic level and is part of the questions related to the environmental factors that can contribute to obesity, type 2 diabetes and the other health outcomes we are looking into in this study.   

 Q: Till what age will you be seeing my baby? 

As indicated in the consent that you’ve signed to enroll in this study, the study is currently funded to follow up on you and your baby for 3 years. However, we are hoping to receive further funding to continue the follow up on you and your baby with your approval. Other similar birth cohort studies like ALSPAC and FAMILY are aiming to follow up their study participants up to their 10th birthday and beyond. The longer the follow up the better we can assess the early beginnings and the environmental factors that can contribute to the health outcomes we’re studying and how such environmental factors can actually modify any genetic predisposition.    

Q: My family doctor says everything is ok with my child—why do I need to see you guys? 

We are not providing any medical care to your child that would replace the medical care provided by your child’s physician. This is a research study that is aiming to assess the causes of certain diseases in South Asians in Canada which will help the health care system provide measures to prevent such diseases in future generations.    

 Q: Why do I need to consent that the health card number of me and my child will be used to track my visits to physicians and hospitals for 15 years?  

Personal health information including the health card numbers of yourself and your child will be shared with the Institute for Clinical Evaluative Sciences and linked to Ontario health records to analyze and evaluate your usage of health care services (such as hospitalizations) in Ontario. A list linking the health card number with your name and your child’s name is kept in a secure place, separate from your files. The health card numbers will also help us obtain data from your physician in cases where you’re not aware of such medical information of if we’re unable to get in touch with you.