Associations Between Feeding Practices and Maternal and Child Weight Among Mothers Who Do Not Correctly Identify Child’s Weight Status Rachel Tabak, PhD, RD; Leah Gable, MSW/MPH expected 2016; Cindy Schwarz MPH, MS, RD; Karen Steger-May, MA; and Debra Haire-Joshu, PhD Center for Obesity Prevention and Policy Research, George Warren Brown School of Social Work and Department of Internal Medicine, Washington University, St. Louis, MO Background & Methods Results Background Child dietary behaviors are associated with parent feeding practices including dietary modeling, food rules, and encouragement. Mothers play an important role in shaping children’s eating patterns, but many are unaware of their children’s weight status, particularly for young children. A mother who underestimates her child’s weight status may be less motivated to promote healthier behaviors (Figure 1). Table 2. Accuracy of mother’s perceptions of child’s weight by category of mother’s weight status (n=230) Accuracy of Categorization Overweight (>=25) Obese (>=30) Morbid obesity 1 (>=35) Morbid obesity 2 (>=40) Total Correct 61.5% (24) 56.8% (50) 53.2% (33) 57.5% (23) 56.8% (130) Healthy Weight 56.4% (22) 48.9% (4) 43.5% (27) 45.0% (18) 84.6% (110) Overweight 5.1% (22) 3.4% (3) 3.2% (2) 2.5% (1) 6.1% (8) Obese 0.0% (0) 4.5% (4) 6.5% (4) 10.0% (4) 9.2% (12) UnderEstimate 38.5% (15) 39.8% (35) 40.0% (16) 40.6% (16) 7.7% (3) 10.2% (9) 16.1% (15) 15.4% (6) 22.7% (20) 19.4% (12) 20.0% (8) 49.5% (46) 6.8% (6) 21.0% (13) 17.5% (7) 34.4% (32) Overestimate* 2.6% (6) 100.0% (39) 100.0% (88) 100.0% (62) 100.0% (40) 100.0% (229) Table 1. Demographics (n=230) Mother Child Age MN = 32 (SD 6) MN = 3.4 (SD 0.8) Race White African American Other 51% 31% 18% 48% 32% 20% BMI/BMI%ile category Overweight Obese 17% 83% 24% Income <$19,999 $20,000-$49,999 $50,000-$74,999 >=$75,000 27% 19% 22% Purpose To explore factors associated with accuracy of maternal weight perception To determine whether maternal feeding practices are associated with maternal and/or child weight status *It was only possible for mothers to over-estimate the weight of their child if the child was normal weight (BMI<85th %ile) Table 3. Correlations between PFQ factors scores and child BMI percentile for the total sample, and among mothers accurately perceiving and underestimating her child’s BMI   Total Sample Underestimate of child's weight Correct perception of child's weight Difficulty in Child Feeding -0.03 -0.11 -0.09 Concern about Child Overeating or Being Overweight .32* 0.16 0.52* Pushing the Child to Eat More -0.07 -0.30* -0.10 Using Food to Calm the Child 0.04 0.01 -0.05 Methods & Measures The HEALTH (Healthy Eating and Active Living Taught at Home) study evaluates the translation of the Diabetes Prevention Program (DPP) into a child development program with obese mothers and their preschool –aged child. Mothers recruited to HEALTH were located in the St. Louis region and had a preschool-aged child at-risk for obesity (60th%ile to 84%ile for BMI) or already overweight or obese (≥85%ile for BMI). Height and weight of the mother and preschooler were collected by trained staff. Mothers completed the Preschooler Feeding Questionnaire (PFQ) 32-items Response options: 1 to 5; never, always, neutral, disagree a lot, agree a lot Values significant at P< 0.05 Conclusions Results Table 1 describes the demographic characteristics Mothers with higher BMI and children who were overweight showed a non-significant trend to over estimate the child’s weight (Table 2) Several correlations between PFQ scales and child BMI% were significant in the total sample or separately for underestimating and correctly perceiving mothers (Table 3) Nearly half of the mothers asked underestimated their child’s weight, considering them to be about the right weight, when they were actually overweight or obese. There were different associations between a child’s actual weight status and the mother’s reported feeding practices among mothers accurately and inaccurately perceiving her child’s weight. Intervention studies should explore targeting education on feeding practices based on these perceptions. Funded by: National Institutes of Health