Brazilian Maternal Weight Perception and Satisfaction With Toddler Body Size: A Study in Primary Health Care

• Inaccuracy of maternal perception of child weight status is a key factor in inappropriate feeding behavior.
• The high prevalence of inaccurate perceptions and maternal dissatisfaction with body size was also observed with toddlers.
• Study findings suggest that health professionals consider the maternal perception of the child's weight beginning in early childhood.

BackgroundMaternal perception and satisfaction with child's weight status are important to detect early and to successfully treat the extremes in weight, especially during early childhood, when the child is more dependent on maternal care.ObjectivesTo assess the inaccuracy of maternal perception of toddler body size and its associated factors and to analyze maternal dissatisfaction with toddler body size.MethodsCross-sectional study with 135 mother–toddler dyads attending Primary Health Care Facilities, São Paulo, Brazil. Children's actual weight status was classified using body mass index-for-age. Inaccuracy and dissatisfaction were assessed using an image scale. We used logistic regression to identify the factors associated with inaccuracy of maternal perception of toddler body size.ResultsInaccuracy in maternal perception was observed in 34.8% of participants. Mothers of excessive weight children were more likely to have inaccurate perceptions (OR = 4.6; 95% CI 2.0–10.7), and mothers of children who attended well-child care were less likely to have inaccurate perceptions (OR = 0.3, 95% CI 0.1–0.9). More than half of mothers (52.6%) were dissatisfied with their toddler's size and desired a larger child (75.0% of mothers of underweight children, 25.0% of mothers whose children were at risk for overweight and 23.0% of mothers of overweight children).ConclusionThe majority of mothers were inaccurate in their perception and was dissatisfied with their toddler's body size. Maternal inaccuracy and dissatisfaction differed by the weight status of the toddler. Attendance at well-child visits was an effective way to decrease maternal inaccuracy, which reinforces the importance of the influence of health professionals.