Objectives: Recent data from the NHANES III study has shown that one of every four children in the United States is obese. Infancy may be one of the critical periods for the development of obesity as investigators have found that infant fatness persists over time, prohibits activity, and has long term effects on later fatness and behavior. The early introduction of solid foods, formula feeding, and maternal characteristics have been established as factors in early infant weight gain. The purpose of this study was to examine the differences between maternal characteristics, infant feeding patterns, and maternal feeding attitudes with infant weight status at six months of age. Design: Cross-sectional, three group, comparative descriptive design. Sample: Mother-infant dyads were recruited from a South Texas public clinic as study participants. Infants were excluded that had feeding problems, congenital malformations, Apgar scores less than seven at one or five minutes, born pre-term or born post-term. All mothers of formula-fed well six-month-old infants were approached for this study. Methods: Grouping of the infants into Group One, Normal Weight Infants, Group Two, Overweight Infants, and Group Three, Obese Infants was based on infant weight and height status. Study Variables: Demographic data for maternal ethnicity, age, marital status, number of people in household, educational level, and employment status was collected from each participant. Feeding patterns were obtained from a survey completed by the mothers. Maternal attitudes toward feeding were assessed by the mothers completing the Maternal Feeding Attitudes Questionnaire. Negative scores indicated "food withholding" feeding attitudes of mothers and positive scores indicated "food pushiness" feeding attitudes of mothers. Results: Fifty-seven mothers of six-month-old infants completed this study. 56.1% were Black, 22.8% were Hispanic, and 21.1% were White by self-identification. There was no significant difference (p=0.176) between the scores on the Maternal Feeding Attitudes Questionnaire between the mothers of Group One, Normal Weight Infants (n=20), and the mothers of Group Two, Overweight Infants (n=20). There was also no significant difference (p=0.122) between the scores on the Maternal Feeding Attitudes Questionnaire of the mothers of Group One, Normal Weight Infants, and the mothers of Group Three, Obese Infants (n=17). Chi Square analysis of feeding patterns and maternal characteristics between the groups were significant for baby food given once a day, additional formula feedings, formula and cereal, nighttime feedings more than once, marital status, and employment status. There were no significant differences across groups for infant weight and length at birth. Conclusions: While there was no significant difference in the scores on the Maternal Feeding Attitudes Questionnaire, the scores on this instrument indicated negative values or "foodwitholding" attitudes for all three groups of infants. There was a sixfold increase in the mean negative scores of mothers as infant weight increased from Normal Weight Infants to Obese Infants. The significance of this result was that maternal attitudes toward feeding did not match infant weight at six months of age. There were significant differences in feeding patterns between groups, indicating that mothers were actually giving their infants extra feedings in the feeding pattern survey. Implications: Mothers may not be aware that they are overfeeding their infants and need more instruction on feeding schedules and amounts of food to be given. Feeding pattern surveys can be utilized to assist health care providers to determine feeding patterns and amounts of food given to infants that may contribute to infants being overweight or obese. Overfeeding needs to be acknowledged as a contributing factor to excess weight gain during infancy.
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