Maternal perspectives on growth and nutrition counseling provided at preschool well-child visits

The inclusion of growth assessment and nutrition-related anticipatory guidance in all well-child visits is recommended. Although prior studies have assessed whether these topics are discussed, the content of the discussions has not been explored from the maternal perspective.

To explore what mothers of preschoolers recall and understand about growth assessment and nutrition anticipatory guidance provided at their child's most recent well-child visit.

Qualitative, semistructured telephone interviews were performed with 20 mothers of preschoolers recruited from a Head Start program. Interviews were recorded and transcribed. Themes were identified and refined in an iterative process.

Three main findings emerged: 1) although mothers generally recalled the use of growth charts and often recalled their child's height and weight percentiles, they were generally unable to articulate the meaning of these percentiles; 2) most mothers stated that their nutrition-related decisions were not influenced by growth chart findings. However, when growth chart findings were interpreted as positive, mothers found them reassuring. Conversely, when growth chart findings were interpreted as negative, mothers discounted the growth chart in favor of other comparisons of growth; 3) a considerable proportion of mothers reported that nutrition was not discussed at the most recent well-child visit, which mothers commonly attributed to a lack of weight or feeding problems for their child.

Among the low-income mothers studied, growth chart use and findings were memorable but frequently misunderstood, while nutrition-related anticipatory guidance was not consistently recalled. These findings suggest opportunities to improve physician-patient communication regarding these topics.