"Whatever average is:" understanding African-American mothers' perceptions of infant weight, growth, and health

Biomedical researchers have raised concerns that mothers' inability to recognize infant and toddler overweight poses a barrier to stemming increasing rates of overweight and obesity, particularly among low-income or minority mothers. Little anthropological research has examined the sociocultural, economic or structural factors shaping maternal perceptions of infant and toddler size or addressed biomedical depictions of maternal misperception as a "socio-cultural problem." We use qualitative and quantitative data from 237 low-income, African-American mothers to explore how they define 'normal' infant growth and infant overweight. Our quantitative results document that mothers' perceptions of infant size change with infant age, are sensitive to the size of other infants in the community, and are associated with concerns over health and appetite. Qualitative analysis documents that mothers are concerned with their children's weight status and assess size in relation to their infants' cues, local and societal norms of appropriate size, interactions with biomedicine, and concerns about infant health and sufficiency. These findings suggest that mothers use multiple models to interpret and respond to child weight. An anthropological focus on the complex social and structural factors shaping what is considered 'normal' and 'abnormal' infant weight is critical for shaping appropriate and successful interventions.