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Table 1 Frequency of specific target parental behaviours and domains coded in early child obesity prevention interventionsa

From: Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review

Target parental behaviour domain and specific target parental behaviours

Number of interventions ( N  = 37)

Infant (milk) feeding practices

32

Promoting and/or sustaining breastfeeding, including exclusive breastfeeding to 6 months of age

27

Feeding formula appropriately, if necessary (e.g. making formula per package instructions, feeding in response to the infant’s hunger/satiety cues, feeding with suitable types of formula)

25

Avoiding overfeeding, by not supplementing breastmilk with formula

16

Delaying introduction of solid foods (complementary feeding) until 6 months of age

28

Food provision and parent feeding practices

33

Behaviours related to dietary intake

 Providing appropriate types of foods (e.g. vegetables, meat and alternatives, fruits, whole grains, dairy)

33

 Providing age-appropriate portions of each food group (i.e. portion sizes; incl. limiting portions of milk)

24

 Limiting provision of certain foods and drinks (e.g. energy-dense, nutrient poor foods, sugar-sweetened beverages)

30

Behaviours related to feeding practices

 Offering foods repeatedly that have previously been rejected

29

 Offering foods and drinks in response to infants’ hunger/satiety cues (e.g. letting the infant decide how much they eat, not pressuring to eat)

31

 Avoiding use of food to control (or reward) the infant’s emotions, behaviour or consumption of other foods

26

 Providing regular meal routines (incl. eating together, limiting distractions)

29

Movement practices

21

Behaviours related to physical activity

 Placing infant on their stomach for prone play (‘tummy time’)

20

 Promoting age-appropriate physical activity such as active play, outdoor play, activities relating to fundamental movement skills

21

 Providing toys that promote movement such as balls and toys on wheels

16

Behaviours related to sedentary behaviour

 Limiting the amount of time the infant is restrained (e.g. prams/strollers, high chairs, strapped on a caregivers back)

18

 Limiting the amount of time the infant is exposed to screens (e.g. television, mobile devices)

21

 Providing alternatives to screen time

20

Sleep health practices

19

Promoting regular sleep routine (e.g. calm, quiet, soothing)

19

Letting the infant settle back to sleep when stirring/crying during sleep cycle (e.g. leaving the room, only picking up infant when awake)

14

Promoting a positive sleep environment (e.g. quiet, darkened, warm)

16

Placing infant in cot/bassinet while awake and letting infant learn to fall asleep (e.g. following infant’s signs of tiredness)

16

Avoiding bed-sharing / co-sleeping (i.e. sleeping with the infant in the same bed)b

12

Maximising day-night differences (e.g. lights on and play in the day, lights off and sleep at night)

9

  1. aN = 32 trials, reporting n = 37 unique intervention arms that completed the validation process. Interventions could target one or more behaviours. Average percent agreement between coders for target parental behaviour domains was 97% (range 75% to 100%)
  2. bIt was noted from validation meetings with trial representatives that bed-sharing is a cultural practice for some populations. Therefore, if bed-sharing was considered culturally appropriate, the intervention approach was to bed-shared safely