Mothers And careGivers Investing in Children (MAGIC)

The incidence of childhood obesity in the United States has steadily increased over the past 30 years but has begun to level off in recent years. Epidemiological evidence indicates that obesity may transmitted across multiple generations. The current study seeks to: 1) evaluate the extent to which grandmothers or other important caregivers affect their mothers' parenting surrounding feeding their child, and 2) examine whether an intervention aimed at improving diet quality and enhancing responsive feeding to improves parental responsivity and feeding behavior and infants' weight trajectories over time.

The incidence of childhood obesity in the United States has steadily increased over the past 30 years, but has begun to level off in recent years. Children from minority groups may be disproportionately affected, such that Hispanic and non-Hispanic Black children have greater weight for recumbent length compared to White children. Similarly, socioeconomic status (SES) may affect child weight status. Epidemiological evidence indicates that obesity may transmitted across multiple generations. Genetics are a factor in determining weight status, but parents are largely responsible for regulating children's dietary environments. Grandparents increasingly provide care for their grandchildren, yet few studies have examined grandparent involvement or the role that grandparents or other significant caregivers play in feeding the child. The objective of the current study is two-fold: 1) to evaluate the extent to which grandmothers and/or other caregivers affect mothers' parenting surrounding feeding their infant, beginning when the infant is first introduced to solid foods; and 2) to examine whether an intervention aimed at providing both mothers and grandmothers or other important caregivers with hands-on training regarding healthy foods and responsive feeding behaviors improves mothers' and grandmothers' feeding behaviors and infants' weight trajectories over time. The researchers will collect both self-report data on diet, child temperament, mothers and other caregivers' mental health, stress and support. Observational assessments will be obtained to code co-caregiver behavior and caregiver responsiveness during feeding.

Primary - BMI percentile at 12 months of age Secondary- Proportion of infants with BMI percentile >85th at 12 months of age Anthropometrics measured directly by trained study staff Infant dietary intake of fruits and vegetables, animal source foods, whole grains, desserts and sweets, and salty snacks at 10 to 11 months. Measured at 10 months using an Infant Diet History questionnaire adapted from the Infant Feeding Practices Study II. Measured at 10 months using the Nutrition Data System for Research (NDSR) Responsive feeding measured using the Infant Feeding Styles Questionnaire (IFSQ) full scale and Chatoor's feeding scale at 10 to 11 months.

Parents will be provided with responsive feeding coaching to help them recognize hunger and satiety cues and nutrition coaching that involves recommending a sequence of introducing complementary foods that corresponds with food textures and feeding styles, breast/bottle weaning, healthy snacking and hands on demonstrations for healthy food options.

Parents will be provided with information about safe sleeping, car seats, baby-proofing, etc., delivered during home visits, newsletters, and reinforcing text messages.

Parents will be provided with responsive feeding coaching to help them recognize hunger and satiety cues and nutrition coaching that involves recommending a sequence of introducing complementary foods that corresponds with food textures and feeding styles, breast/bottle weaning, healthy snacking and hands on demonstrations for healthy food options.

Infant dietary intake of fruits and vegetables, animal source foods, whole grains, desserts and sweets, and salty snacks at 11 months of age

Measured at 10-11 months using an Infant Diet History questionnaire adapted from the Infant Feeding Practices Study II. Measured at 10 to 11 months using the Nutrition Data System for Research (NDSR)

Inclusion Criteria: Mothers with babies aged 4 to 5 months Other caregivers assisting the mother with the baby. Babies aged 4 to 5 months Exclusion Criteria: Babies with metabolic or feeding issues. Mothers younger than 16 years of age.