Nutritional Assessment and Maternal Perception of Toddler Body Size using Toddler Silhouette Scale in Nigeria a Developing Country

Abstract

Background and Objectives:The toddler silhouettes scales have been validated in the caucascian population in developing countries but in the African population, the use of these scales is yet to be evaluated. The aim of this study was to determine the perception of mothers on the body size of toddlers using a validated scale in an African population.Methods:This was a cross sectional study of 241 mothers and their toddlers. Study participants were recruited from the immunization and pediatric clinics. The mothers’ perceptions of the body sizes of toddlers and their own child was determined with the use of a validated 7-scale toddler silhouette. Each mother also assessed their own child with the scale. Each child’s anthropometry was documented.Results:Majority of the mothers were able to correctly classify the underweight (95.0%) and overweight toddler silhouettes (95.7%). However, 30% of the respondents misclassified Silhouette 6 (overweight silhouette) as normal and 48.2% of the respondents misclassified a normal silhouette as underweight. The overall maternal accuracy in assessing their toddler size was 41.1%. There was a significant relationship between maternal accuracy and the maternal educational status, tribe, and toddler size.Conclusions and Global Health implications:Toddler silhouette scales is a quick way of assessing the body size of children and could be of significant use in the developing countries. There is a need for caregivers to accurately assess the body size of their children as this will significantly influence the food mothers will give their children and thus children’s eventual growth and development.

Body size preferences and food choice among mothers and children in Malawi

“…Mothers in our study were less accurate at assessing their child's weight status than their own, with only half correctly identifying their child's weight. The overall percentage correct in our study was similar to findings from a study in Nigeria, which used the same type of silhouettes, and both studies found that mothers were more likely to underestimate their child's weight status if the child was overweight (Adeniyi et al, 2018). These findings fit the pattern in high‐ and middle‐income countries showing that parents are generally inaccurate at assessing child weight status (Doolen, Alpert, & Miller, 2009; Lundahl et al, 2014; Moffat, 2000) and tend to underestimate the weight status of overweight children (Francescatto et al, 2014).…”

“…We identified only one study of child body size preferences in sub‐Saharan Africa, conducted in Nigeria. It showed that 35% of mothers underestimated and 24% overestimated their child's body size (Adeniyi, Ekure, Olatona, Ajayi, & Nworgu, 2018).…”

“…However, there is little research to date on the link between body size perceptions or preferences and food choice. In addition, there is limited research on maternal perceptions of child body size in sub-Saharan Africa (Adeniyi et al, 2018) and the association of maternal body size with mothers' preferences for child body size. This formative research study was conducted with the aim of understanding Malawian mothers' body size perceptions and preferences for themselves and their child and the relationship of these perceptions and preferences with food choices.…”

Maternal Dissatisfaction About Toddler’s Body Size And Its Relationship To Children’s Eating Behaviours

“…Mean score from each indicator were measured. Mother's satisfaction was assessed using Toddler Silhouette Questionnaire, which consists of 2 sets of 7 children's picture with number 1 (thinnest) to 7 (fattest) 12 . Mother asked to choose picture's number that describe (1) the body size that most closely resembled their child, and (2) the body size that she want their child to be, and score is obtained from the difference set (1) minus set (2).…”