Maternal Perceptions of Child’s Nutritional Status in Rural, Indigenous Ixil Women from Guatemala

Abstract

Abstract Objectives To describe maternal perceptions of child's body image in a sample of indigenous women and children from the Ixil ethnic group in Guatemala. Methods A cross-sectional, semi-structured survey was administered to a sample of 46 mothers of 2 to 6-year-old children. The survey included questions on maternal, child and sociodemographic factors and perceptions of the child's nutritional status, and a silhouette scale with differing body sizes. Anthropometry was measured for both mothers and children and used to calculate Body Mass Index (BMI) and anthropometric z-scores for the children, based on international protocols. Pearson and Spearman correlations were used to evaluate associations between mother and child's BMIs and maternal short stature with child stunting, respectively. Results Mean age of children was 45.9 ± 12.6 months; 57% exhibited moderate stunting [height-for-age z-score (zHAZ) ←2], 25% had severe stunting (zHAZ ←3) and 20% were at risk of overweight, or overweight (zBMI > 1). In the mothers, 82% had short stature (<150.3 cm), 25% were overweight (BMI = 25–30 kg/m2), and 20% obese (BMI > 30 kg/m2). The 43.5% of mothers underestimated their child's actual body size; 54% accurately denoted it, and 2.2% overestimated their child's actual body size. When asked the question “which of these silhouettes are healthy children,” silhouettes representing overweight/obese children were interpreted as “healthy” by 28% of the mothers. In addition, 18% misclassified underweight children as “healthy.” Maternal and child BMIs were not significantly correlated (r = 0.3, P = 0.07), nor maternal short stature with child stunting, (r = 0.02, P = 0.86). Conclusions The double burden of malnutrition in this sample is clear and evident. Almost half of the women misclassified the nutritional status of their child. Further research is suggested to understand if the misconceptions of a child's nutritional status influence their feeding practices in this population. Funding Sources The Mathile Institute for the Advancement of Human Nutrition.