Maternal Perceptions of Toddler Body Size

Abstract

Objectives: To examine (1) accuracy of maternal perceptions of toddler body size; (2) factors associated with accuracy of toddler body size; and (3) how maternal satisfaction relates to accuracy/toddler body size. Design: Cross-sectional. Setting: Low-income community sample from suburban Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)/urban pediatric clinics. Participants: Two hundred eighty-one mother-toddler dyads (toddlers: 54.1% male; mean age, 20.2 months; 70.8% African American; 8.5% underweight [<15th weight-for-length percentile]; and 29.2% overweight [≥85th weight-for-length percentile]). Main Exposure: Measured anthropometry (mother/toddler) and demographics. Outcome Measure: Validated toddler silhouette scale (accuracy and satisfaction). Results: Nearly 70% of mothers were inaccurate in assessing their toddler’s body size. Compared with mothers of healthy-weight toddlers, mothers of underweight toddlers were 9.13 times more likely to be accurate (95% CI, 2.94-28.36) and mothers of overweight toddlers were 87% less likely to be accurate (95% CI, 0.05-0.33); accuracy did not differ by toddler age, sex, or race or mother’s education or weight status. More than 70% of all mothers and 81.7% of mothers of overweight toddlers were satisfied with their toddler’s body size. Accurate mothers of underweight toddlers were less likely to be satisfied than accurate mothers of healthy-weight toddlers (30.0% vs 76.8%; P< .001). Conclusions: Mothers of overweight toddlers had inaccurate perceptions of their toddler’s body size and were highly satisfied, suggesting a view of heavy toddlers as normative. Mothers of underweight toddlers had accurate perceptions yet were dissatisfied, suggesting recognition of their child as outside the norm. Because inaccurate perceptions begin early in toddlerhood, pediatric providers should help improve families’ understanding of healthy body size. Future studies should examine how satisfaction and accuracy relate to parenting behaviors.

Promoting Healthy Growth or Feeding Obesity? The Need for Evidence-Based Oversight of Infant Nutritional Supplement Claims

“…In a world of rising childhood obesity, perpetrating a need for weight gain among healthy children who are below the 25th percentile in weight-for-height is potentially harmful. This marketing strategy plays on well-documented perception errors of mothers regarding their children’s size [95] and is likely to exacerbate rather than alleviate the global child overweight and obesity trend. …”

Design of a Digital-Based, Multicomponent Nutrition Guidance System for Prevention of Early Childhood Obesity

“…The perceived risk of early childhood obesity is a central component because of prevailing beliefs about larger infants being healthier or better [48, 61, 62], tendencies to practice unresponsive feeding such as pressuring, despite acknowledging infant satiety cues [63, 64], failure to perceive overweight children as overweight [62, 65], and a general belief that young children will grow out of any early overweight or obese status [61, 66]. …”

Percepção materna da imagem corporal de seus filhos em aleitamento materno exclusivo

“…(9) Mothers demonstrated knowledge about the representation of a "child with normal weight," although their statements demonstrate a distance from this concept This was identified in other studies which observed no correlation between visual and verbal maternal perception in the classification of their children's weight, especially when they were overweight or obese (14) and the imprecision in maternal perception when assessing their overweight child, and also highlighting their satisfaction with the child's excess weight. (15) The opposite can also be ascertained when the mothers whose children were underweight, showed dissatisfaction for believing that their children were outside a standard image and weight expected for their age group. (15) Although none of the children in this study can be classified as obese, four mothers underestimated their children's weight, classifying them with appropriate weight, even though they were at risk of overweight/overweight.…”

“…(15) The opposite can also be ascertained when the mothers whose children were underweight, showed dissatisfaction for believing that their children were outside a standard image and weight expected for their age group. (15) Although none of the children in this study can be classified as obese, four mothers underestimated their children's weight, classifying them with appropriate weight, even though they were at risk of overweight/overweight. These results are similar to the findings of another study, which found out that parents did not perceive overweight or obesity in their children.…”