Research report Parental perception of child weight in the first two years-of-life: a potential link between infant feeding and preschoolers’ diet ☆ Salma M.A. Musaad a, *, Sharon M. Donovan b , Barbara H. Fiese a , the STRONG Kids Research Team 1 a Family Resiliency Center, Department of Human and Community Development, University of Illinois at Urbana-Champaign, 904 W. Nevada, MC-081, Urbana, IL 61801, USA b Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA ARTICLE INFO Article history: Received 26 August 2014 Received in revised form 25 March 2015 Accepted 27 March 2015 Available online 2 April 2015 Keywords: Parental perception Obesity Pediatric nutrition Breastfeeding A B ST R AC T Approximately 23% of preschoolers are overweight or obese. Establishing a healthy dietary lifestyle at an early age can improve later child diet and body weight. This study examined the determinants of past infant feeding practices that do not follow standard feeding recommendations (breastfeeding for less than 6 months duration, cow’s milk prior to the first year of age and solid foods at or before 4 months of age). It also examined the role of parental perception of child weight in the first 2 years-of-life on past infant feeding practices as well as current child diet and body weight. Families of 497 preschoolers aged 22– 63 months (39.0 ± 8.2) were recruited from 30 child care centers in East-Central Illinois. Main findings indicate that past infant feeding practices were common and varied by socio-demographic factors in- cluding race/ethnicity, parental education and child gender. Children perceived as overweight in the first 2 years-of-life tended to breastfeed for lesser duration. Additionally, the majority (79.8%) of preschool- ers who were classified as overweight using BMI percentile were perceived as non-overweight by the parent in the first 2 years-of-life. Mean daily total fatty/sugary food intake was higher among those per- ceived to be non-overweight in the first 2 years-of-life. These findings have identified parental perception of child weight in the first 2 years-of-life as a modifiable risk factor for unhealthy child diet and obesity among preschoolers. © 2015 Elsevier Ltd. All rights reserved. Introduction In the U.S., the prevalence of overweight or obesity in pre- school children (aged 2–5 years) has decreased from 26.7% in 2009– 2010 (Ogden, Carroll, Kit, & Flegal, 2012) to 22.8% in 2011–2012 (Ogden, Carroll, Kit, & Flegal, 2014), yet it still remains a public health concern. Additionally, the prevalence of severe obesity remains high (Skinner & Skelton, 2014). In an attempt to promote healthy infant feeding and prevent childhood obesity, the American Academy of Pediatrics recommends a number of desired infant feeding practices. These feeding practices include exclusive breastfeeding for at least 6 months, the introduction of solid foods around 6 months of age and exposing the baby to a wide variety of healthy foods, con- suming human milk or formula for the first year-of-life and avoiding the introduction of sugar-sweetened beverages (American Academy of Pediatrics, 2012; Clayton, Li, Perrine, & Scanlon, 2013). Prior research has explained the adverse effects of not adher- ing to these infant feeding practices. For example, lack of breastfeeding is associated with high maternal control of feeding (Brown & Lee, 2013a) and mothers who breastfeed for more than 3 months demonstrate higher responsiveness to child fullness cues (DiSantis, Hodges, & Fisher, 2013). However, a limitation of the ex- isting literature is information on the prevalence and characteristics of infants that deviate from one or more of these feeding stan- dards (Clayton et al., 2013; Fox, Reidy, Novak, & Ziegler, 2006). Moreover, studies often relate these specific infant feeding prac- tices to child diet during the first 24 months-of-life (Brown & Lee, 2012, 2013b; Fisher, Birch, Smiciklas-Wright, & Picciano, 2000; Fox et al., 2006; Grummer-Strawn, Scanlon, & Fein, 2008; Hodges et al., 2013; Woo et al., 2013). However, limited information relating infant feeding to child diet in later preschool years is available (Saavedra, Deming, Dattilo, & Reidy, 2013; Vilela et al., 2014). It is important to better understand these relationships because early childhood ☆ Acknowledgements: The authors would like to thank the participating families as well as the following funding sources: U.S. Department of Agriculture (Hatch 793- 328) to Barbara Fiese (PI), Illinois Council on Food and Agricultural Research Sentinel Grant to Kris Harrison, University of Illinois Health and Wellness grant to Sharon Donovan and Barbara Fiese, the Dairy Research Institute to Barbara Fiese and Sharon Donovan (PI’s) and the Christopher Family Foundation Food and Family Program. * Corresponding author. E-mail address: smusaad@illinois.edu (S.M.A. Musaad). 1 The STRONG Kids Research Team includes Kristen Harrison, University of Illi- nois at Urbana Champaign, Kelly Bost, Brent McBride, Sharon Donovan, Diana Grigsby- Toussaint, Juhee Kim, Janet Liechty, Angela Wiley, Margarita Teran-Garcia, Barbara Fiese. http://dx.doi.org/10.1016/j.appet.2015.03.029 0195-6663/© 2015 Elsevier Ltd. All rights reserved. Appetite 91 (2015) 90–100 Contents lists available at ScienceDirect Appetite journal homepage: www.elsevier.com/locate/appet