Value of video-based education to enhance infant motor development.

BACKGROUND: Parents play a vital role in promoting infant motor development and physical activity; however, there is little information available to parents on how to support healthy movement. Therefore, the purpose of this study was to assess the feasibility of implementing video-based education to improve infant physical activity and motor development. METHODS: This multiple case study consisted of semi-structured interviews with mothers (n = 12) and early childhood experts (n = 5, e.g., pediatrician, home visitor). Participants watched pre-recorded videos and answered questions which were developed following Bowens and colleagues guide for designing feasibility studies. Data were analyzed using a directed content analysis approach. RESULTS: Most mothers (91.7 %) reported they were highly likely to recommend the videos to others and said the best way to share these videos would be through an app or social media (83.3 %) or health care entities (e.g., hospital, pediatrician, 75 %). Half of mothers (50 %) reported they would be interested in seeing videos once a month or once every couple of months. Further, all experts agreed parents would be somewhat or highly likely to use the videos and a majority (80 %) stated they were highly likely to recommend and share videos like these. Experts' top suggestions for sharing the videos was through an app/social media (40 %) and credible websites (40 %). DISCUSSION: Overall, the videos appear feasible for mothers. Both groups primarily suggested that videos be disseminated through social media, online, or through an app. Future research should engage parents and healthcare providers in developing videos.

The feasibility of a mystery case curriculum to enhance diagnostic reasoning skills among medical students: a process evaluation.

OBJECTIVES: Within a Hospital Medicine division at a large academic institution, an innovative program has been developed to offer third year medical learners enrolled in their Internal Medicine Clerkship the opportunity to deepen their diagnostic reasoning skills with a weekly case-based learning activity entitled "Hospital Medicine's Mystery Case of the Week". The mystery case curriculum has four primary learning objectives (1): To understand the value of employing a multisystem approach to a common presenting problem (2); To apply a diagnostic schema to a clinical problem (3); To apply knowledge of cost appropriate workups to a clinical case and (4) To identify cognitive biases that can influence decision making in the context of treating a clinical problem. METHODS: A process evaluation of the mystery case curriculum was conducted over a 6-month implementation period. The process evaluation was guided by eight domains of focus: program acceptability, demand, implementation, practicality, adaptation, integration, expansion and limited-efficacy testing. Measures included a pre/post mixed-methods survey, attendance log and timesheet. Pre/post survey data was analyzed via paired samples t-tests and open-ended responses were analyzed via a deductive content analysis. RESULTS: Process evaluation findings demonstrated the program had high levels of acceptability and demand. Survey findings suggest the curriculum may increase feelings of preparedness for Internal Medicine exams as well as student interest, comfort and confidence related to diagnostic processes. CONCLUSIONS: Future evaluations should work to understand the influence this curriculum has on diagnostic accuracy within a clinical setting.

Pelvic floor dysfunction in rural postpartum mothers in the United States: prevalence, severity, and psychosocial correlates.

Pelvic floor dysfunction (PFD) is a common gynecological problem; however, women residing in rural communities may refrain from seeking treatment for PFD. The purpose of this study was to characterize severity of PFD among postpartum women residing in rural communities (<50,000 residents) in the United States and explore the demographic and psychosocial correlates of PFD. METHODS: A survey packet comprised of the Pelvic Floor Disability Index (PFDI-20) and Prolapse and Incontinence Knowledge Questionnaire (PIKQ) as well as the Edinburgh Perinatal Depression Screening (EPDS), items from the Canadian Sexual Health Indicator (CSHI) survey, and demographic questions were distributed via electronic link following recruitment using social media. Descriptive statistics were calculated, and multivariate logistic regression was used to assess the factors associated with PFDI-20 score. RESULTS: Participants (n = 383) have limited pelvic health knowledge (PIKQ) despite self-reporting moderate symptoms of dysfunction (PFDI-20). Over half of women scored ≥14 on the EPDS, indicating probable depression. Women with high scores on the EPDS had greater odds of reporting moderate/severe PFD. Women that identified as Black and/or having a college degree were more likely to report moderate/severe PFD. CONCLUSION: Rural women require further support to improve their physical and psychological health in the postpartum period.

"We don't talk about it enough": Perceptions of pelvic health among postpartum women in rural communities.

PURPOSE: A descriptive qualitative study was conducted to explore perceptions and experiences related to pelvic health in the postpartum period among a cohort of women residing in communities with less than 50,000 residents. METHODS: A semi-structured interview approach guided by the Theory of Planned Behavior was used. Postpartum individuals (<6 months since childbirth) were interviewed in the fall/winter of 2021-2022. RESULTS: Specific to individuals' attitudes toward pelvic health, women viewed Kegels as an important component to improving pelvic health but had a negative attitude toward their own pelvic health, often identifying their pelvic floor as "weak." The subjective norms influencing a woman's perception were typically, a positive influence by family/friends and the Internet, although the Internet was viewed as an insufficient resource. Healthcare providers were noted as an infrequent and ineffective resource for education and support in the postpartum period. Finally, women's perceived behavioral control to manage their pelvic health was influenced by limited knowledge of pelvic health and time, and a desire for more education from their primary care provider and geographical barriers. CONCLUSION: Innovative strategies are needed to support postpartum women's pelvic health within rural communities. Primary care providers may benefit from the development of "quick tips" by specialists, such as women's health physical therapists, to optimize pelvic health discussions with their postpartum patients. Education interventions targeted toward postpartum women in rural communities should focus on strategies that address the geographic barriers identified while still providing individualized care. Options, such as webinars, telehealth, and text message interventions, could be considered.

A qualitative comparison of parent and childcare provider perceptions of communication and family engagement in children's healthy eating and physical activity.

BACKGROUND: Parents and childcare providers play a substantial role in the development of health behaviours among the children they care for. In order to ensure the optimal growth and development of children, communication and family engagement in childcare is critical. Previous studies examining parent or provider perceptions about healthy eating or physical activity have explored these concepts individually and/or have only included only parents or providers. Therefore, the purpose of this study was to compare childcare provider and parent perceptions of communication regarding healthy eating and physical activity as well as use of best practice strategies on family engagement for these topics. METHODS: Childcare providers (n = 12) in childcare centres or a family childcare home and a parent (n = 12) of a child they provide care for participated in a semi-structured interview guided by the Social Ecological Model. Interviews were transcribed verbatim and uploaded to NVivo for data analysis. Data were analysed using a directed content analysis. Three trained qualitative researchers developed a codebook and then compared responses between parents and providers. RESULTS: Similarities in provider and parent responses included agreement on healthy eating; influences on child development; parents being the most influential on children's healthy eating; how they identified physical activity opportunities; and the use of family engagement principles. Differences that arose included parents' roles in promoting children's physical activity; challenges for parents in promoting healthy eating and physical activity; and providers' encouragement of physical activity. Importantly, few parents mentioned providers were top influences on their child's healthy eating or physical activity. Providers also mentioned having difficult conversations with parents was challenging. CONCLUSIONS: Future efforts are needed to (1) help parents understand the providers' role in the development of their child's health behaviours and (2) strengthen efforts to engage families in healthy behaviours outside of childcare facilities.

Early impact of the COVID-19 pandemic on promotion of infant activity, strength and communication: A qualitative exploration.

INTRODUCTION: Fostering physical activity, muscle strengthening and communication skills in diverse environments are vital to ensuring healthy infant development; however, promotion of these skills may be impacted by the COVID-19 pandemic. Therefore, the purpose of this study was to explore healthcare workers, parents and childcare providers' perceptions of the pandemic's influence on how they engage with infants to promote physical activity, muscle strength and communication. METHODS: 37 subjects (12 = parents; 12 = childcare providers, 13 = healthcare workers) participated in a semi-structured interview. Data were analyzed via an inductive content analysis. RESULTS: The majority of caregivers identified concerns related to: limitations in social interactions (especially masks impacting communication), lack of access to peer modeling, fewer opportunities for physical exploration, and a need for creative activities in diverse environments (e.g., home/childcare) for infant development during and after the pandemic. CONCLUSIONS: Caregivers are concerned about the role COVID-19 is having on infant development. Additional resources on how to promote infant physical activity, muscle strength and communication despite challenges associated with the COVID-19 pandemic are needed.

Examining supports and barriers to breastfeeding through a socio-ecological lens: a qualitative study.

BACKGROUND: Early breastfeeding cessation is a societal concern given its importance to the health of mother and child. More effective interventions are needed to increase breastfeeding duration. Prior to developing such interventions more research is needed to examine breastfeeding supports and barriers from the perspective of breastfeeding stakeholders. One such framework that can be utilized is the Socio-Ecological Model which stems from Urie Broffenbrenner's early theoretical frameworks (1973-1979). The purpose of this study was to examine supports and barriers to breastfeeding across environmental systems. METHODS: A total of 49 representatives participated in a telephone interview in Nebraska, USA in 2019. Interviewees represented various levels of the model, based on their current breastfeeding experience (i.e., mother or significant other) or occupation. A direct content analysis was performed as well as a constant comparative analysis to determine differences between level representatives. RESULTS: At the Individual level, breastfeeding is a valued behavior, however, women are hindered by exhaustion, isolation, and the time commitment of breastfeeding. At the Interpersonal level, social media, peer-to-peer, and family were identified as supports for breastfeeding, however lack of familial support was also identified as a barrier. At the community level, participants were split between identifying cultural acceptance of breastfeeding as support or barrier. At the organizational level, hospitals had supportive breastfeeding friendly policies in place however lacked enough personnel with breastfeeding expertise. At the policy level, breastfeeding legislation is supportive, however, more specific breastfeeding legislation is needed to ensure workplace breastfeeding protections. CONCLUSION: Future efforts should target hospital-community partnerships, family-centered education, evidence-based social media strategies and improved breastfeeding legislation to ensure breastfeeding women receive effective support throughout their breastfeeding journey.

A Cross-Sectional Examination of Physical Activity, Sedentary Time, and Sleep Between Adults With and Without Children in the Home Using the National Health and Nutrition Examination Survey.

BACKGROUND: Physical activity (PA), sedentary behavior, and sleep are interconnected, promoting optimal health. Few studies have examined these factors holistically. Therefore, the purpose of this study was to capture the 24-hour activity cycles of the US population by examining PA, sedentary behavior, and sleep based on the presence of a child within the home, as well as gender and weight. METHODS: Cross-sectional health-related variables from the National Health and Nutrition Examination Survey were used for analysis. The primary variables were the total and type of PA (recreation, work, and active transportation), sedentary behavior, and sleep. Chi-square and regression models were applied to compare the outcomes across participants' characteristics. RESULTS: The adults with children within the home reported less recreational PA, more work activity, less sedentary activity, and less sleep, but no differences in total PA. The females with children in the home not only had the lowest levels of recreational activity and sleep, but also the lowest levels of sedentary behavior. The obese individuals with children in the home had less sedentary time than the adults without children in the home, regardless of weight status. CONCLUSIONS: Unhealthy sleep and PA behaviors are prevalent in adults with children living at home, and women are particularly impacted.

Perspectives of infant active play: a qualitative comparison of working versus stay-at-home parents.

BACKGROUND: Parents play a key role in infant's development through their interactions and the type of environment they provide to promote active play. The amount of time parents are able to spend with their infant is dependent on their working status, yet few studies have explored parent perception of their infant's active play by working status. The purpose of this study was to explore parent perception of active play and compare responses between working and stay-at-home parents. METHODS: Twenty-nine parents participated in this qualitative study by completing a one-time, in-person semi-structured interview based on the Theory of Planned Behavior. Themes were developed and compared based on parental working status using a directed content analysis approach. RESULTS: All parents believed active play could have a positive effect on their child's development through physical, social and emotional, cognitive, and/or language and communication development. However, stay-at-home parents reported a broader impact of active play across these domains; whereas working parents most often referenced active play as impacting infant's physical development. Social and emotional interactions were the highest reported form of active play among all parents. Additionally, all parents described similar barriers to increasing the time for active play. The most commonly reported barrier for all parents was time or schedule followed by care needs of the infant, environmental concerns, and need for restrictive devices (e.g., car seats). More stay-at-home parents than working parents reported the care needs of the infant as being a barrier. Recommendations for active play were not widely known amongst all parents, with a higher percentage of working parents reporting they would desire advice from a healthcare provider. CONCLUSIONS: Working status of parents appears to have implications on perceptions of active play which in turn may influence infants' development. Future studies should objectively assess the impact of parents' working status on infant development and explore how gender of the parent may serve as a confounding variable.

Exploring parents' provision of factors related to the establishment of physical activity between normal weight and overweight infants.

PURPOSE: Infancy is a critical time for the prevention of obesity and establishment of healthy behaviors such as physical activity that help to control weight. A limited amount of research has examined if factors related to infant physical activity vary by infant weight status. Therefore, the purpose of this mixed methods triangulation study was to examine differences in motor development, the home environment, and infant-parent play behaviors as well as to explore how parents promote active play opportunities with normal weight infants (NWIs) and overweight infants (OWIs). DESIGN AND METHODS: We used a mixed methods triangulated approach to combine quantitative and qualitative data strands to examine variables associated with active play in normal weight (n = 16) and overweight (n = 11) infants. Data were analyzed using a two-tailed Mann-Whitney U nonparametric test and a summative content analysis approach. RESULTS: Although there were no differences in infants' motor development and parent play behaviors based on infant weight, several other differences were found. OWIs had less access to materials that stimulate locomotor movement. Further, parents of OWIs more often reported utilizing cognitive play strategies in comparison to parents of NWIs who more often reported using physical play strategies. Parents felt they were the greatest influence on their child's activity regardless of infant size. Importantly, all parents desired more specific guidelines on how to encourage active play and preferred this information was delivered by their healthcare provider. PRACTICE IMPLICATIONS: To meet parents' desires and potentially improve infants' developmental outcomes through the establishment of healthy physical activity behaviors, pediatric nurses could provide more specific guidance on providing active opportunities for infants.

Social Support During COVID-19: Perspectives of Breastfeeding Mothers.

Introduction: Effective social support can have a critical influence on a mother's ability to initiate and continue breastfeeding. Coronavirus disease (COVID-19) has created unprecedented barriers for breastfeeding mothers to obtain various types of support: emotional, instrumental, informational, and appraisal. However, no research has evaluated the influence the pandemic has had on breastfeeding supports. The purpose of this study was to explore perceptions of social support among breastfeeding mothers during the COVID-19 pandemic. Materials and Methods: A cross-sectional phenomenological approach was taken utilizing semistructured interviews (March-June 2020) with currently breastfeeding mothers (n = 29). Data were analyzed through a process of immersion and crystallization. Results: Mothers are still able to obtain each type of support, however, support has been negatively influenced by the pandemic. Mothers reported experiencing increased stress and isolation and had an immense desire to receive in-person support from peers, family, childcare providers, and lactation specialists. Furthermore, mothers of multiple children felt if they did not already have breastfeeding knowledge from previous experiences they would be unsuccessful in breastfeeding due to their current lack of support. Conversely, a majority of mothers felt the pandemic had positively influenced their breastfeeding journeys due to concerns of formula shortages and extended maternity leaves. Finally, mothers were concerned about safely expressing breast milk on their return to work. Conclusion: Mother's ability to obtain breastfeeding support has been negatively impacted by the pandemic due to the inability to engage with individuals in-person and the lack of access to childcare. First-time mothers may be at higher risk of early breastfeeding cessation due to lack of support. However, breastfeeding journeys have also been positively influenced by allowing mothers more time at home with their child. Resources are needed to support expressing breast milk in the workplace during COVID-19.

Healthy eating and physical activity among breastfeeding women: the role of misinformation.

BACKGROUND: Eating healthy, being physically active and breastfeeding can greatly support a new mother's physiological and psychological health. However, within the United States, only 8.5% of women are meeting fruit and vegetable recommendations and only 35% of women are maintaining their pre-pregnancy physical activity after childbirth. Preliminary investigations suggest barriers such as lack of time and knowledge hinder a breastfeeding woman's ability to eat well and be physically active. The purpose of this study was to explore women's perceptions of healthy eating and physical activity while breastfeeding. METHODS: This qualitative study utilized a 33-question semi-structured interview guide developed using the constructs of Self-Determination Theory. Data were analyzed via the process of immersion/crystallization. RESULTS: A total of 24 breastfeeding women completed a roughly 40-min telephone interview. The mean age of the mother was 32 ± .88 and the mean age of the child being breastfed was 8.5 ± 1.4 months old. Findings demonstrate mothers see value in engaging in physical activity primarily for reasons related to self-care. In addition, breastfeeding women have a lack of information and support regarding healthy eating and physical activity while breastfeeding and many are receiving misinformation through resources such as Facebook support groups. Finally, mothers want more resources available that focus specifically on healthy behaviors while breastfeeding. CONCLUSION: Women need greater access to education and resources regarding healthy eating and physical activity while breastfeeding. Ideally, information and resources would come from an educated health professional such as their healthcare provider rather than an internet source.

Exploring gender differences in infant motor development related to parent's promotion of play.

This study explored how parents' promotion of play may impact gender differences in motor development of six-nine month old infants. Twenty-nine infants between six-nine months of age and their primary caregivers took part in assessments of anthropometry, motor development, video observations of play and a qualitative interview. Results revealed females had significantly higher scores for fine motor skills and significantly higher incidence of touching toys in an individual play scenario compared to males. Males had a higher intensity level of play during both play scenarios. Qualitative explorations found that parents perceived other adults such as surrounding family and friends to promote gender differences but not themselves; however, parents' verbal interactions with infants did appear to differ by gender. Parents of males more frequently made statements to promote gross motor skills while parents of females more frequently made statements to promote fine motor skills. While biological influences are suggested to play a role on gender differences of motor development early in life, environmental explanations related to socialization, gender-differentiated expectations and experiences amplify these differences to a greater degree than may have been previously considered during this time period.

The impact of body mass index and sociodemographic factors on moderate-to-vigorous physical activity and sedentary behaviors of women with young children: A cross-sectional examination.

OBJECTIVES: Moderate-to-vigorous physical activity provides multiple benefits to women after childbirth. To achieve these benefits, the recommendation that adults obtain, 150 min of moderate-to-vigorous physical activity per week and reduce sedentary behaviors, also applies to women in the post-partum phase of the life span. However, research examining the moderate-to-vigorous physical activity and sedentary behaviors of women with young children (0-2 years) is limited. A greater understanding of these behaviors from a nationally representative sample is needed. Therefore, the primary objective of this study was to determine the levels of moderate-to-vigorous physical activity and sedentary behaviors of a nationally representative sample of women with young children within the United States. A secondary objective was to examine the influence of body mass index and sociodemographic factors on these behaviors. METHODS: Cross-sectional data from four cycles of the National Health and Nutrition Examination Survey (2007-2008, 2009-2010, 2011-2012, and 2013-2014) were used for analysis. Descriptive statistics were calculated and a generalized linear model was used to investigate associations between mean minutes of moderate-to-vigorous physical activity, sedentary activity, body mass index, and sociodemographic variables. DISCUSSION: Women with young children (n = 477) obtained 634 min in moderate-to-vigorous physical activity per week and this was positively associated with having a higher income (p < 0.001) and the number of children in the home (p < 0.001). In total, 62% of women were meeting the World Health Organization guidelines for aerobic activity. Lower odds of achieving guidelines was associated with being Black (p = 0.004), Mexican American (p = 0.009), or married (p = 0.042) compared with being White or not married. Finally, women accumulated ~5 h of sedentary activity per day, with higher levels associated with race (p = 0.005), education (p = 0.022), and number of children within the home (p < 0.001). Research efforts should continue to focus on strategies to help non-adhering women with young children achieve the physical activity recommendations and reduce time spent in sedentary behaviors.

Affordances in the Home Environment for Motor Development-Infant Scale, Spanish Translation.

BACKGROUND: The home environment has a critical influence on an infant's development and well-being. The Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) is an instrument that has been developed to assess the home environment. This article illustrates the translation, validation and cultural adaptation process of the AHEMD-IS from English to Spanish. METHODS: The AHEMD-IS underwent a comprehensive process involving a four-phase translation process: 1) Forward translation, 2) Semantic equivalence, 3) Content equivalence testing, and 4) Final version development. RESULTS: Steps 1 & 2 resulted in linguistic alterations from the initial translation to enhance clarity for general public understanding. In step 3, mothers reported the instrument was clear and easy to complete. Step 4 involved a final review of the instrument. CONCLUSION: The final outcome is a validated instrument that may prove beneficial when evaluating the home environment with Spanish-speaking populations, particularly those of Mexican descent.

Mental and physical support (MAPS) for moms: preliminary findings from a prenatal health support program.

BACKGROUND: The low incidence of exercise during pregnancy and the high rates of prenatal depression indicate more opportunities are needed for mothers to engage in exercise and obtain health-related support and education. MAPS (mental & physical support) was developed to support mothers' psychological and physical health during pregnancy. MAPS consisted of physical activity classes 2×/week followed by either a speaker or group discussion regarding a parenting or health-related topic. The primary purpose of this study was to determine if the format was feasible prior to developing a main scale randomized trial. METHODS: Program measurements included a pre/post survey, post-program focus group, attendance logs and scales for exercise, self-efficacy, and social support. RESULTS: Findings indicated the program format is well-received by participants; however, issues in attendance warrant program format alterations. Further, larger scale studies and the addition of a control group are needed. CONCLUSION: This format offers practitioners an effective strategy for supporting pregnant women's physical and psychological health.

Workplace Breastfeeding Support Varies by Employment Type: The Service Workplace Disadvantage.

BACKGROUND: The majority of women are returning to work full-time after childbirth, and support within their place of employment may influence intention and duration for breastfeeding, but more research is needed. Therefore, the purpose of this study was to explore the influence of employment type on breastfeeding duration upon return to work by examining informal (i.e., verbal encouragement) and direct (i.e., lactation space, flexible time) factors of support. METHODS: This was a retrospective survey of women's returning-to-work experiences while breastfeeding. Survey contents included respondent demographics as well as questions surrounding perceptions of employer support, work environment, and goal/satisfaction regarding breastfeeding. Data were analyzed via crosstabs and chi-square goodness of fit tests. RESULTS: A total of 1,002 women completed the survey. Significant differences were seen across different employment types. Women within the professional/management industry were most likely to receive informal and direct support for breastfeeding upon return to work. Women within the service industry and production/transportation industry reported receiving the lowest levels of informal and direct support. CONCLUSION: Workplace support varies by employment type and women in the service and production/transportation industry appear to be at a disadvantage compared with other employment types. There is a need for more breastfeeding support programs to be developed that target specific workplace characteristics.

He's just content to sit: a qualitative study of mothers' perceptions of infant obesity and physical activity.

BACKGROUND: Rates of obesity among children ages zero to five are rapidly increasing. Greater efforts are needed to promote healthy behaviors of young children. Mothers are especially important targets for promoting health as mothers' views play a vital role in helping their children foster healthy habits from an early age. Research has found parents' views of infants' weight may influence their feeding practices; however, limited research has explored mothers' view of infants' weight in relation to the promotion of physical activity. Therefore, the purpose of this study was to explore the perceptions of mothers of normal weight infants and overweight infants about their infant's weight and physical activity. METHODS: Semi-structured interviews were conducted with mothers of normal weight (n = 18) and of overweight (n = 11) infants (6.5 ± 0.5 month) in a Midwestern city in the United States. A thematic analysis was used to analyze the data. RESULTS: A majority of mothers thought infants could be overweight. However, no mothers referenced their own infant as overweight. Mothers most commonly noted infants could be overweight only if they were formula fed and/or were overfed, not if they were breastfed. Mothers views were not negatively influenced by others who mentioned that their child was either "big" or "small" and only one mother had been told her infant was overweight. A majority of mothers thought an infant could be physically active. When discussing infant activity, mothers primarily referred to it in terms of general mobility and a few thought activity level was related to a personality characteristic. Mothers intended to promote physical activity in the future either through outdoor play or specific organized activities such as sports. Despite a majority of mothers stating they were currently physically active themselves, only a few talked about interacting with their infant to promote their infant's physical activity. CONCLUSIONS: Efforts are needed by healthcare professionals and other public health professionals to inform mothers about the dangers of increased weight during infancy as well as the importance of interacting with infants to promote physical activity.

Postural control strategies differ in normal weight and overweight infants.

BACKGROUND: Evidence suggests obesity can have a negative influence on a child's motor development and postural control behavior. Little research has examined the impact of infant weight on gross motor behavior, particularly postural control at the onset of sitting. OBJECTIVE: The purpose of this study was to determine whether normal weight and overweight infants differed in their postural control strategies at the onset of sitting and one-month post onset of sitting. METHODS: 29 infants (n=19 normal weight, n=10 overweight) were recruited to participate in this study. Infant's length and weight were measured at 3 months of age (visit 1). Infant's center of pressure (COP) was measured on an AMTI force platform at the onset of sitting (visit 2) and one-month post onset (visit 3). Data were analyzed using linear measures (range and RMS for the anterior/posterior (AP) and medial/lateral (ML) directions, sway path) and nonlinear measures (Sample Entropy in AP and ML directions). RESULTS: Overweight infants had significantly greater RMS values in the ML direction at visit 2 and reduced Sway Path values in comparison to normal weight infants at visits 2 and 3. Further, there was a significant difference in Sample Entropy as overweight infants increased Sample Entropy from visit 2 to 3 while normal weight infants decreased Sample Entropy values during this time period. CONCLUSIONS: These findings suggest that overweight infants adopt a different postural control strategy. This altered strategy may limit exploration early in development. More research is needed to determine if longitudinal differences continue to emerge.