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Parents' beliefs about appropriate infant size, growth and feeding behaviour: implications for the prevention of childhood obesity

Sarah A Redsell1*, Philippa Atkinson2, Dilip Nathan3, A Niroshan Siriwardena4, Judy A Swift5 and Cris Glazebrook6

Author Affiliations

1 School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Queen's Medical Centre, B Floor, South Block, Nottingham, NG7 2HA, UK

2 Nottingham City Primary Care Trust, 1 Standard Court, Nottingham. NG1 6GN, UK

3 Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK

4 School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK

5 School of Biosciences, University of Nottingham, Nottingham, LE12 5RD, UK

6 School of Community Health Sciences, University of Nottingham, Nottingham, NG7 2HA, UK

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BMC Public Health 2010, 10:711  doi:10.1186/1471-2458-10-711

Published: 18 November 2010



A number of risk factors are associated with the development of childhood obesity which can be identified during infancy. These include infant feeding practices, parental response to infant temperament and parental perception of infant growth and appetite. Parental beliefs and understanding are crucial determinants of infant feeding behaviour; therefore any intervention would need to take account of their views. This study aimed to explore UK parents' beliefs concerning their infant's size, growth and feeding behaviour and parental receptiveness to early intervention aimed at reducing the risk of childhood obesity.


Six focus groups were undertaken in a range of different demographic localities, with parents of infants less than one year of age. The focus groups were audio-recorded, transcribed verbatim and thematic analysis applied using an interpretative, inductive approach.


38 parents (n = 36 female, n = 2 male), age range 19-45 years (mean 30.1 years, SD 6.28) participated in the focus groups. 12/38 were overweight (BMI 25-29.99) and 8/38 obese (BMI >30). Five main themes were identified. These were a) parental concern about breast milk, infant contentment and growth; b) the belief that the main cause of infant distress is hunger is widespread and drives inappropriate feeding; c) rationalisation for infants' larger size; d) parental uncertainty about identifying and managing infants at risk of obesity and e) intentions and behaviour in relation to a healthy lifestyle.


There are a number of barriers to early intervention with parents of infants at risk of developing obesity. Parents are receptive to prevention prior to weaning and need better support with best practice in infant feeding. In particular, this should focus on helping them understand the physiology of breast feeding, how to differentiate between infant distress caused by hunger and other causes and the timing of weaning. Some parents also need guidance about how to recognize and prepare healthy foods and facilitate physical activity for their infants.